Department of Paediatric Cardiology, Great Ormond Street National Health Service Trust, London, United Kingdom.
Department of Paediatric Cardiology, Our Lady's Children's Hospital, Crumlin, Dublin.
J Heart Lung Transplant. 2015 Jun;34(6):806-14. doi: 10.1016/j.healun.2014.12.010. Epub 2014 Dec 20.
No data are available for the outcome of children undergoing cardiac transplantation with shared care programs in different countries. We sought to investigate the outcome of a shared care transplant program between 2 countries given the complex immunologic, cardiac, and psychologic needs of these young people.
We investigated the results of a shared care program for children who underwent cardiac transplantation between our center in the Republic of Ireland and 2 centers in the United Kingdom over 2 decades.
Between 1990 and 2013, 22 patients underwent 23 cardiac transplants. The median age at transplant was 3.2 years (range, 0.3-13.3 years), median age at listing was 30 months (range, 0.1-13.3 years), and the median waiting list time was 2.8 months (range, 0.3-14 months). The median time to return to the referral center from the time of transplant was 3 weeks (range, 2-8 weeks). The referral center treated 4 of 5 late rejection episodes. Angiography was undertaken in the transplant center at annual or biannual review. Outcomes for rejection, coronary vasculopathy, and survival were comparable between the referral and transplant centers.
This report of shared care for pediatric transplant patients between 2 sovereign nations demonstrates good results, with comparable outcomes to the specialist transplant center. These data may encourage liberalization of follow-up in other centers.
目前尚无数据可用于评估在不同国家实施共同照护计划的儿童心脏移植结局。鉴于这些年轻人复杂的免疫、心脏和心理需求，我们试图调查两国间共同照护移植项目的结局。
我们调查了我们所在的爱尔兰共和国中心与英国的 2 个中心之间 20 多年来开展的儿童心脏移植共同照护计划的结果。
1990 年至 2013 年间，22 例患者接受了 23 例心脏移植。移植时的中位年龄为 3.2 岁（范围，0.3-13.3 岁），登记时的中位年龄为 30 个月（范围，0.1-13.3 岁），中位等待时间为 2.8 个月（范围，0.3-14 个月）。从移植到返回转诊中心的中位时间为 3 周（范围，2-8 周）。转诊中心治疗了 5 例晚期排斥反应中的 4 例。在移植中心每年或每两年进行一次血管造影复查。转诊和移植中心的排斥、冠状动脉血管病和生存率的结果相似。
本报告介绍了 2 个主权国家之间开展的儿科移植患者共同照护情况，结果良好，与专科移植中心的结局相当。这些数据可能鼓励其他中心放宽随访要求。
