[Experience of pediatric cardiac transplantation in the Cleveland Clinic Foundation].

Brain death was not approved on the patients under 6 years old in Japan now. It is impossible to perform cardiac transplantation on the small children. Between October 1997 and November 1998, cardiac transplantation was performed by pediatric cardiac surgical team in 11 children at the Cleveland Clinic Foundation. 7 patients were cardiomyopathy under 18 years old and 4 were congenital heart diseases in all ages. 8 were status 1 and 2 were requiring extracorporeal membrane support. Bicaval technique was exclusively utilized. There was one early death due to multiple organ failure. 10 patients underwent myocardial biopsy and the half of them had more than 3 A rejection. These acute rejections were controlled with steroid pulse therapy and OKT-3 treatment. We took part in the management of patients with pediatric cardiac transplantation at the Cleveland Clinic Foundation. Practical patient cares were described in this report.