Infant heart transplantation 1991.

Between November 1985 and June 1991, there were 118 orthotopic heart transplantations performed on 117 infants less than 1 year old. Indications for transplantation were dominated by complex congenital heart disease (92%). Weight ratio between donor and recipient was 1.75 +/- 0.72 and ischemic time was 255 +/- 121 minutes. Early mortality was 10.2% and 5-year actuarial survival was 79%. Rejection diagnoses have been achieved mainly with noninvasive techniques. The immunosuppression regimen was comprised of daily cyclosporine A and azathioprine. Steroids were used only for rejection treatment. These results are encouraging and comparable to those of adult transplantation. The shortage of organ donors remains a major problem in pediatric transplantation.