Long-term outcomes of pediatric heart transplantation in single-ventricle heart disease: A single-center analysis.
Objective and Aims: Pediatric heart transplantation (HTx) for children with single-ventricle (SV) physiology remains a complex and high-risk procedure. This study aimed to retrospectively evaluate long-term outcomes in patients with SV undergoing primary HTx versus HTx after failed staged palliation...
| Publicado en: | Annals of Pediatric Cardiology Vol. 18; no. 6; pp. 541 - 551 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wolters Kluwer India Pvt Ltd
Nov/Dec2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=192310396&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 192310396 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09742069 589G jtl: Annals of Pediatric Cardiology issn: 09742069 maglogo: N pubinfo: dt: Nov/Dec2025 vid: 18 iid: 6 pid: 16919 pub: Wolters Kluwer India Pvt Ltd artinfo: ui: 192310396 192310396 192310396 10.4103/apc.apc_209_25 192310396 ppf: 541 ppct: 10 formats: tig: atl: Long-term outcomes of pediatric heart transplantation in single-ventricle heart disease: A single-center analysis. aug: au: Rosenthal, L. Lily Netz, Heinrich Haas, Nikolaus A. Grinninger, Carola Hörer, Jörgen Michel, Sebastian Hagl, Christian Fischer, Marcus affil: Division for Pediatric and Congenital Heart Surgery, LMU University Hospital Munich, Munich, Germany sug: subj: Heart Septal Defects, Ventricular Heart Transplantation Pediatric Surgery Heart Defects, Congenital Treatment Outcomes Hypoplastic Left Heart Syndrome Treatment Failure Human Male Female Retrospective Design Palliative Care Survival Rate Descriptive Statistics Cytomegaloviruses Epstein-Barr Virus Infections Confidence Intervals Descriptive Research T-Tests Fisher's Exact Test Chi Square Test Data Analysis Software Extracorporeal Membrane Oxygenation Infant, Newborn Infant Child, Preschool Child Adolescence Infant, Newborn: birth-1 month Infant: 1-23 months Child, Preschool: 2-5 years Child: 6-12 years Adolescent: 13-18 years Male Female ab: Objective and Aims: Pediatric heart transplantation (HTx) for children with single-ventricle (SV) physiology remains a complex and high-risk procedure. This study aimed to retrospectively evaluate long-term outcomes in patients with SV undergoing primary HTx versus HTx after failed staged palliation. Methods: Between 1991 and 2025, 22 pediatric patients (aged ≤ 18 years) with SV physiology underwent orthotopic HTx. Thirteen received primary HTx (Group 1), and nine had HTx after failed staged palliation (Group 2), including two post-Norwood, three post-Glenn, and four post-Fontan procedures. Results: The 10-year survival rate was 71.6%, with similar re-transplant-free survival. The median transplant age was 0.22 years (interquartile range [IQR], 0.08–0.49) for Group 1 and 15.1 years (IQR, 3.0–16.5) for Group 2. Posttransplant extracorporeal membrane oxygenation was needed in three patients in Group 1 and six patients in Group 2. Coronary vasculopathy (grades I–III) occurred in eight patients in Group 1 and 5 patients in Group 2; one patient in each group underwent re-HTx. Cytomegalovirus positivity was found in three and one patients; Epstein–Barr virus positivity in six and two patients (Groups 1 and 2, respectively). Rejection (grades 0–II) occurred in 7 and 2 patients, respectively. Posttransplant lymphatic disorder developed in four patients (Group 1). Immunosuppression was changed in 10 patients (Group 1) and 6 patients (Group 2). Three patients in Group 1 required pacemakers. Conclusions: HTx is feasible for pediatric SV patients. Primary Tx in infancy may involve shorter operative times, whereas HTx after failed palliation, especially post-Fontan, is more complex and associated with higher morbidity. Early referral and tailored treatment are essential. Multicenter prospective studies are needed to improve patient selection and address donor availability. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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