Hostname: page-component-5c6d5d7d68-vt8vv Total loading time: 0.001 Render date: 2024-08-07T17:50:01.018Z Has data issue: false hasContentIssue false

Cardiac transplantation for hypoplastic left heart syndrome

Published online by Cambridge University Press:  21 September 2005

Robert J. Boucek
Affiliation:
Department of Pediatric Cardiology, Congenital Heart Institute of Florida and University of South Florida/All Children's Hospital, Saint Petersburg, Florida, USA
Maryanne R. K. Chrisant
Affiliation:
Children's Hospital of Philadelphia, Philadelphia, USA

Extract

Cardiac transplantation is now a therapeutic option with good outcomes for infants and children with end-stage cardiac failure or inoperable congenital cardiac defects.1 In 2000, 356 procedures in children aged up to 18 years were reported to the United Network for Organ Sharing – International Society of Heart and Lung Transplantation Registry.2 Congenital cardiac disease was the most common indication in children less than 1 year of age, and overall was the most common diagnosis leading to cardiac transplantation in children. As a result of the groundbreaking contributions of Bailey et al.,3 transplantation is now an option for primary treatment of infants with hypoplastic left heart syndrome born in the United States of America. The availability of donor organs, however, both limits the number of children with hypoplastic left heart syndrome who can be realistically offered transplantation, and contributes significantly to morbidity, mortality, and costs. Current limitations in the identification and availability of donors would not allow transplantation to be the primary option for all children born with hypoplastic left heart syndrome. Analyses of the database of the Registry, however, indicated that only about half of donations resulted in transplantation of the heart.4 These observations provide compelling evidence of significant opportunities to improve rates of donation, and to utilize better the existing donations, with emphasis on optimizing identification of donors, expanding the number of potential donors, and better distribution of the available organs.

Type
Heart Transplantation
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Fricker FJ, Addonizio L, Bernstein D, Boucek M, Boucek R, Canter C, Chinnock R, Chin C, Kichuk M, Lamour J, Pietra B, Morrow R, Rotundo K, Shaddy R, Schuette EP, Schowengerdt KO, Sondheimer H, Webber S. Heart transplantation in children: indications. Report of the Ad Hoc Subcommittee of the Pediatric Committee of the American Society of Transplantation (AST). Pediatr Transplantation 1999; 3: 333342.Google Scholar
Boucek MM, Faro A, Novick RJ, Bennett LE, Keck BM, Hosenpud JD. The Registry of the International Society for Heart and Lung Transplantation: Fourth Official Pediatric Report – 2000. J Heart Lung Transplant 2001; 20: 3952.Google Scholar
Bailey LL, Nehlsen-Cannarella SL, Doroshow RW, Jacobson JG, Martin RD, Allard MW, Hyde MA, Dang Bui RH, Petry EL. Cardiac allotransplantation in newborns as therapy for hypoplastic left heart syndrome. N Engl J Med 1986; 315: 949951.Google Scholar
Renlund DG, Taylor DO, Kfoury AG, Shaddy RS. New UNOS rules: historical background and implications for transplantation management. United Network for Organ Sharing. J Heart Lung Transplant 1999; 18: 10651070.Google Scholar
Kichuk-Chrisant MR, Naftel D, Drummond-Webb J, Chinnock R, Canter C, Boucek M, Boucek RJ Jr, Hallowell S, Kirklin J, Morrow W. Fate of Infants with Hypoplastic Left Heart Syndrome Listed for Cardiac Transplantation: A Multicenter Study. Circulation 1999; 100 (Suppl.): I97.Google Scholar
Bailey L, Concepcion W, Shattuck H, Huang L. Method of heart transplantation for treatment of hypoplastic left heart syndrome. J Thorac Cardiovasc Surg 1986; 92: 15.Google Scholar
Akintuerk H, Michel-Behnke I, Valeske K, Mueller M, Thul J, Bauer J, Hagel K, Kreuder J, Vogt P, Schranz D. Stenting of the arterial duct and banding of the pulmonary arteries: basis for combined Norwood stage I and II repair in hypoplastic left heart. Circulation 2002; 105: 10991103.Google Scholar
Rosenthal DN, Dubin AM, Chin C, Falco D, Gamberg P, Bernstein D. Outcome while awaiting heart transplantation in children: a comparison of congenital heart disease and cardiomyopathy. J Heart Lung Transplant 2000; 19: 751755.Google Scholar
Bove EL. Surgical treatment for hypoplastic left heart syndrome. Jpn J Thorac Cardiovasc Surg 1999; 47: 4756.Google Scholar
Bando K, Turrentin MW, Sun K, Sharp TG, Caldwell RL, Darragh RK, Ensing GK, Cordes TM, Flaspohler T, Brown JW. Surgical management of hypoplastic left heart syndrome. Ann Thorac Surg 1996; 62: 7076.Google Scholar
Jenkins PC, Flanagan MF, Jenkins KJ, Sargent JD, Canter CE, Chinnock RE, Vincent RN, Tosteson AN, O'Connor GT. Survival analysis and risk factors for mortality in transplantation and staged surgery for hypoplastic left heart syndrome. J Am Coll Cardiol 2000; 36: 11781185.Google Scholar
Sigfusson G, Fricker FJ, Bernstein D, Addonizio LJ, Baum D, Hsu DT, Chin C, Miller SA, Boyle GJ, Miller J, Lawrence KS, Douglas JF, Griffith BP, Reitz BA, Michler RE, Rose EA, Webber SA. Long-term survivors of pediatric heart transplantation: a multicenter report of sixty-eight children who have survived longer than five years. J Pediatrics 1997; 130: 862871.Google Scholar
Boucek RJ Jr, Naftel D, Boucek MM, Chinnock R, Morrow RW, Pahl E, DiSano S. Induction immunotherapy in pediatric heart transplant recipients: a multicenter study. J Heart Lung Transplant 1999; 18: 460469.Google Scholar
Pahl E, Naftel DC, Canter CE, Frazier EA, Kirklin JK, Morrow WR. Pediatric Heart Transplants Death after rejection with severe hemodynamic compromise in pediatric heart transplant recipients: a multi-institutional study. J Heart Lung Transplant 2001; 20: 279287.Google Scholar
Chinnock R, Sherwin T, Robie S, Baum M, Janner D, Mellick L. Emergency department presentation and management of pediatric heart transplant recipients. Pediatr Emerg Care 1995; 11: 355360.Google Scholar
Chinnock R, Baum M. Somatic growth in infant heart transplant recipients. Pediatr Transplant 1998; 2: 3034.Google Scholar
Bailey L, Assaad A, Trimm R, Nehlsen-Cannarella S, Kanakriyeh M, Haas G, Jacobson J. Orthotopic transplantation during early infancy as therapy for incurable congenital heart disease. Annals of Surgery 1988; 208: 279286Google Scholar
Leonard HC, O'Sullivan JJ, Dark JH. Long-term follow-up of pediatric cardiac transplant recipients on a steroid-free regime: the role of endomyocardial biopsy. J Heart Lung Transplant 2000; 19: 469472.Google Scholar
Eke C, Gundry S, Baum M, Chinnock R, Razzouk A, Bailey L. Neurologic sequelae of deep hypothermic circulatory arrest in cardiac transplant infants. Ann Thorac Surg 1996; 61: 783788.Google Scholar
Hornung TS, de Goede CGO, Brien C, Moghal NE, Dark JH, O'Sullivan F. Renal function after pediatric cardiac transplantation: the effect of early cyclosporin dosage. Pediatrics 2001; 107: 13461350.Google Scholar
Canter C, Naftel D, Caldwell R, Chinnock R, Pahl E, Frazier E, Kirklin J, Boucek M, Morrow R. Survival and risk factors for death after cardiac transplantation in infants. A multi-institutional study. The Pediatric Heart Transplant Study. Circulation 1997; 96: 227231.Google Scholar
Ibrahim J, Sweet SC, Flippin M, Dent C, Mendelhoff E, Huddleston CB, Trinkhaus K, Canter CE. Rejection is reduced in thoracic organ recipients when transplanted in the first year of life. J Heart Lung Transplant 2002; 21: 311318.Google Scholar
West LJ, Pollock-Barziv SM, Dipchand AI, Lee KJ, Cardella CJ, Benson LN, Rebeyka IM, Coles JG. ABO-incompatible heart transplantation in infants. N Engl J Med 2001; 344: 793800.Google Scholar
Vigano A, Esposito S, Arienti D, Zagliani A, Massironi E, Principi N, Clerici M. Differential development of type 1 and type 2 cytokines and beta-chemokines in the ontogeny of healthy newborns. Biol Neonate 1999; 75: 18.Google Scholar
Schelonka RL, Raaphorst FM, Infante D, Kraig E, Teale JM, Infante AJ. T cell receptor repertoire diversity and clonal expansion in human neonates. Pediatr Res 1998; 43: 396402.Google Scholar
Schelonka RL, Infante AJ. Neonatal immunology. Semin Perinatol 1998; 22: 214. [Review]Google Scholar
Neubert R, Delgado I, Abraham K, Schuster C, Helge H. Evaluation of the age-dependent development of lymphocyte surface receptors in children. Life Sci 1998; 62: 10991110.Google Scholar
Bakker JM, Kavelaars A, Kamphuis PJ, Zijlstra J, van Bel F, Heijnen CJ. Neonatal dexamethasone treatment induces long-lasting changes in T-cell receptor vbeta repertoire in rats. Journal of Neuroimmunology 2001; 112: 4754.Google Scholar
Kavelaars A, Catso B, Visser GH, Zegers BJ, Bakker JM, van Rees EP, Heunen CJ. Ontogency of the responses of human peripheral blood T cells to glucocorticoids. Brain Behav Immun 1996; 10: 288297.Google Scholar
Wells WJ, Parkman R, Smogorzewska E, Barr M. Neonatal thymectomy: does it affect immune function? J Thorac Cardiovasc Surg 1998; 115: 10411046.Google Scholar
Boucek MM, Pietra B, Sondheimer H, Luna M, Shaffer E, Hall P, Campbell D. Anti-T-cell-antibody prophylaxis in children: success with a novel combination strategy of mycophenolate mofetil and antithymocyte serum. Transplant Proc 1997; 29: 16S20S.Google Scholar
Wekerle T. Transplantation tolerance induced by mixed chimerism. J Heart Lung Transplant 2001; 20: 816823.[Review]Google Scholar