Division of Pediatric Cardiac Surgery, Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Korean Med Sci. 2011 May;26(5):593-8. doi: 10.3346/jkms.2011.26.5.593. Epub 2011 Apr 21.
Heart transplantation is a standard treatment for end-stage heart disease. Pediatric heart transplantation, however, is not frequently performed due to the shortage of pediatric heart donors. This is the first report of pediatric heart transplantation in Korea. Our retrospective study included 37 patients younger than 18 yr of age who underwent heart transplantation at Asan Medical Center between August 1997 and April 2009. Preoperative diagnosis was either cardiomyopathy (n = 29, 78.3%) or congenital heart disease (n = 8, 22.7%). Mean follow up period was 56.9 ± 44.6 months. There were no early death, but 7 late deaths (7/37, 18.9%) due to rejection after 11, 15, 41 months (n = 3), infection after 5, 8, 10 months (n = 3), suspicious ventricular arrhythmia after 50 months (n = 1). There was no significant risk factor for survival. There were 25 rejections (25/37, 67.6%); less than grade II occurred in 17 patients (17/25, 68%) and more than grade II occurred in 8 patients (8/25, 32%). Actuarial 1, 5, and 10 yr survival was 88.6%, 76.8%, and 76.8%. Our midterm survival of pediatric heart transplantation showed excellent results. We hope this result could be an encouraging message to do more pediatric heart transplantation in Korean society.
心脏移植是治疗终末期心脏病的标准方法。然而，由于儿科供体心脏短缺，儿科心脏移植并不常见。这是韩国首例儿科心脏移植报告。我们的回顾性研究纳入了 1997 年 8 月至 2009 年 4 月期间在 Asan 医疗中心接受心脏移植的 37 名年龄小于 18 岁的患者。术前诊断为心肌病（n = 29，78.3%）或先天性心脏病（n = 8，22.7%）。平均随访时间为 56.9 ± 44.6 个月。无早期死亡，但 7 例晚期死亡（7/37，18.9%），发生于 11、15、41 个月（n = 3）时因排斥反应，5、8、10 个月（n = 3）时因感染，50 个月（n = 1）时因疑似室性心律失常。无明显的生存危险因素。有 25 例排斥反应（25/37，67.6%）；17 例（17/25，68%）为小于 2 级，8 例（8/25，32%）为大于 2 级。1、5 和 10 年的生存率分别为 88.6%、76.8%和 76.8%。我们的儿科心脏移植中期生存结果显示出优异的结果。我们希望这一结果能为韩国社会开展更多儿科心脏移植提供鼓舞人心的信息。
