Heart Transplantation in 47 Children: Single-center Experience from China

Background: To perform a retrospective analysis of 47 cases of pediatric heart transplantation in a single Chinese center.

Methods: The study included 47 cases of heart transplantation under 18 years old, completed between Sep 1, 2008 and Dec 31, 2018. We carried out statistical analysis of the clinical features of the donors and recipients, perioperative information, postoperative complications and short- and mid-term survival.

Results: The study included 24 males and 23 females. The average age on transplantation was 10.34±4.80 years (minimum 3 months, median 11.00 years). Preoperative diagnosis included 36 cases of cardiomyopathy, 9 cases of complex congenital heart disease (CHD), and 2 cases of cardiac tumor. Four patients received cardiac surgery before. The donors' average age was 20.89±11.84 years, including 19 donors under 18 years old and 28 donors over 18 years old. The mean donor/recipient body weight ratio was 1.58±0.58. The mean duration of intraoperative cardiopulmonary bypass (CPB) was 119.00±53.47 minutes, in which the mean CPB-assist time was 79.71±48.21 minutes. The average duration of postoperative mechanical ventilation was 32.00 (18.50-54.00) hours, and the average intensive care unit (ICU) stay was 7.00 (4.94-11.28) days. Postoperative complications occurred in 20 cases (42.55%). The 1-year, 3-year, and 5-year survival rate after operation was 95.74%, 93.01%, and 93.01% respectively.

Conclusions: Heart transplantation is an effective means for end-stage heart disease in children. The clinical outcome of pediatric heart transplantation in our center is satisfactory, with low incidence of postoperative complications and high short- and mid-term survival rates.