PEDIATRIC HEART-TRANSPLANTATION - RESULTS OF 2-YEAR AND 5-YEAR FOLLOW-UP

Pediatric heart transplantation has become an accepted method of treat ment for certain pediatric heart disease. From July 1986 to January 19 93, we performed 25 orthotopic pediatric heart transplantations at the University of Minnesota Hospital and Clinics in 16 male patients and nine female patients. The average age was 8.5 years with a range from 7 days to 18 years. Three of the patients were younger than 1 year of age. The indications for transplantation included congenital heart dis ease in six patients and cardiomyopathy in 19 patients. Four of the pa tients with congenital heart disease had previously undergone a cardia c surgical procedure. Two patients with cardiomyopathy had mechanical assist devices in place at the time of transplantation. Donor age rang ed from 2 months to 36 years. The donor organ ischemic time ranged fro m 60 minutes to 329 minutes, with an average of 191 minutes. Follow-up ranged from 6 to 84 months. Overall, there were seven deaths (28%) in the patients undergoing transplantation. Of the seven deaths, four (1 6%) were early (within 30 days) and three (14.3%) were late. The four early deaths were a result of donor organ failure, and the three late deaths a result of acute rejection. The 2-year survival for patients w ith a minimum 24-month evaluation was 79% (15 of 19). Of 12 patients a vailable for 5-year assessment, 75% (9 of 12) were alive and doing wel l at the time this article was written. Pediatric heart transplantatio n can provide good intermediate and long-term survival for selected pe diatric patients.