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Chapter 39 - Failing Cardiac Transplant

from Section 6 - Heart Failure, Mechanical Circulatory Support, and Transplantation

Published online by Cambridge University Press:  09 September 2021

By
Kelly Chilson  and
James Fehr
Edited by
Laura K. Berenstain  and
James P. Spaeth
Laura K. Berenstain
Affiliation:
Cincinnati Children's Hospital Medical Center
James P. Spaeth
Affiliation:
Cincinnati Children's Hospital Medical Center
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Summary

Cardiac transplantation is a life-saving procedure for children with heart failure unresponsive to medical management. Congenital heart disease remains the most common indication for recipients under 1 year of age. Dilated cardiomyopathy, the most common etiology for transplantation in the older child, is increasingly a reason for heart transplantation in patients <1 year of age. Complications of cardiac transplantation in the early postoperative period include acute rejection, anastomotic related issues with the transplanted heart, and postoperative infection. Chronic complications include rejection, infection, and cardiac allograft vasculopathy. Children with heart failure do not always appear ill despite compromised cardiac function, and this chapter aids in the perioperative assessment and management of a patient with a failing heart transplant.

Keywords

cardiac catheterizationcongenital heart diseaseextracorporeal membrane oxygenationheart failureheart transplantventricular assist device
Type
Chapter
Information
Congenital Cardiac Anesthesia
A Case-based Approach
 , pp. 299 - 304
Publisher: Cambridge University Press
Print publication year: 2021

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References

References

Dipchand, A. I.. Current state of pediatric cardiac transplantation. Ann Cardiothorac Surg 2018; 7: 31–55.CrossRefGoogle ScholarPubMed
Jooste, E. H., Muhly, W. T., Ibinson, J. W., et al. Acute hemodynamic changes after rapid intravenous bolus dosing of dexmedetomidine in pediatric heart transplant patients undergoing routine cardiac catheterization. Anesth Analg 2010; 111: 1490–6.CrossRefGoogle ScholarPubMed
Schwartz, L. I., Miyamoto, S. D., Stenquist, S., et al. Cardiac arrest in a heart transplant patient receiving dexmedetomidine during cardiac catheterization. Semin Cardiothorac Vasc Anesth 2016; 20: 175–8.CrossRefGoogle Scholar
Elhoff, J. J., Chowdhury, S. M., Taylor, C. L., et al. Decline in ventricular function as a result of general anesthesia in pediatric heart transplant recipients. Pediatr Transplant 2016; 20: 1106–10.CrossRefGoogle ScholarPubMed

Suggested Reading

Conway, J., Manlhiot, C., Kirk, R., et al. Mortality and morbidity after retransplantation after primary heart transplant in childhood: an analysis from the registry of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2014; 33: 241–51.CrossRefGoogle ScholarPubMed

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