Il trapianto cardiaco in eta pediatrica: Undici anni di esperienza

Translated title of the contribution: Pediatric heart transplantation: Eleven years experience

F. Parisi, C. Squitieri, A. D. Abbattista, A. Carotti, G. Catena, M. P. Cicini, P. D'Argenio, R. Di Donato, F. Esu, V. Lucidi, S. Malena, S. Nappo, A. Rossi, P. Tabarini, A. Turchetta, P. Vezzoli, G. Vinciguerra

Research output: Contribution to journalArticle

Abstract

In 1996, the Thirteenth Official Report of the ISHT Registry reports 1.310 heart transplant to children under 5 years of age and 2.233 in patients under 16 years. Their 3-year actuarial survival rate is about 66%. Contradictory results on morbidity and mortality have been reported. The experience of 'Bambino Gesu' Hospital during the decade 1986-1996 is reported. From November 1985 up to December 31, 1996 128 patients (64 males, 64 females) with an age ranging from 1 day to 18 years (mean age 4,7 yrs, median 3 yrs) have been listed for heart transplant. Nine patients were removed from the list for various reasons, 10 are at present in the waiting list, 47 (36.1%) died after a mean wait of 3.1 months, 62 underwent transplant after a mean wait of 4 months. Two patients underwent retransplantation, both six years after the first transplant. The 64 transplanted patients: (including the 2 retransplants) had a mean age of 61 months; 10 patients were under 1 year of age. Their indications were: cardiomyopathy in 46 patients, congenital heart defects in 18. The 1-, 5-, and 11 year actuarial survival rate for the 64 patients who underwent heart transplantation is 68%, 62%, and 42%, respectively. The 5- and 11- year actuarial survival rate for the 43 patients with a survival of more than 1 year is 93% and 63%, respectively. The follow-up of the 64 patients ranges from 0 to 132 months, with a mean follow-up of 39 months. The overall survival is 60%. 14 patients died peri-operatively. Causes of late deaths were: acute rejection during the first year in three patients, and infection in four (fungine in 2 and viral in 2); after the first year, 2 patients died of chronic rejection (both patients were listed for re-transplantation), two died for family non compliance and one of a rare metabolic disease. At present, 36 patients, included the 2 retransplanted ones, are alive. 32 of them have normal growth, development, and neurologic outcome. We conclude that heart transplant may give a good intermediate and long-term survival in selected pediatric patients; the extension of indications may bring to less encouraging results, but should not be definitely excluded. Apart from the surgical risk, patients transplanted for congenital heart diseases may have a more favourable long-term follow-up compared to that of patients transplanted for various forms of cardiomyopathies.

Original languageItalian
Pages (from-to)79-88
Number of pages10
JournalPediatria Oggi Medica e Chirurgica
Volume17
Issue number4
Publication statusPublished - 1997

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Parisi, F., Squitieri, C., Abbattista, A. D., Carotti, A., Catena, G., Cicini, M. P., D'Argenio, P., Di Donato, R., Esu, F., Lucidi, V., Malena, S., Nappo, S., Rossi, A., Tabarini, P., Turchetta, A., Vezzoli, P., & Vinciguerra, G. (1997). Il trapianto cardiaco in eta pediatrica: Undici anni di esperienza. Pediatria Oggi Medica e Chirurgica, 17(4), 79-88.