Pediatric Cardiac Transplantation - Surgical Aspects

Pediatric heart transplantation is rarely performed in France where almost 20 patients are reported a year.Two different types of receivers are distinguished: in 60% of cases, patients are suffering from cardiomyo pathy. The operation is exactly the same as for an adult patient except for the size. On the other hand, in 30 to 40% of cases, heart transplantation is the last issue for children with congenital heart diseases who have supported several prior operations. In this group of patients, malformation can present considerable challenges to the operative team. Several publications have addressed quite extensively various surgical strategies aimed at heart transplantation for complex congenital heart disease. Key consideration includes issues of anomalies of systemic return, anomalies of the great arteries or anomaly of atrial situs.Results of pediatric heart transplant are close to the results obtained in adults with a survival rate around 45% at 15 years. Patients with congenital heart diseases have higher operative risk but same survival during follow-up. Pediatric cardiac transplantation for end-stage cardiac failure is a reasonable alternative which offers excellent functional results.