Cardiology Department, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois, USA.
Curr Opin Pediatr. 2019 Oct;31(5):583-591. doi: 10.1097/MOP.0000000000000805.
To provide an international perspective and current review of pediatric heart transplantation (PHTx).
Waitlist survival and long-term outcomes in PHTx continue to improve. Strategies to maximize donor pool utilization include ABO incompatible listing for infants and expanded donor-to-recipient weight ranges. However, there is a high degree of practice variation internationally, from listing strategies and donor acceptance practices to chronic immunosuppression regimens, long-term graft surveillance, and consideration for retransplantation.
Common indications for PHTx include end-stage congenital heart disease and cardiomyopathy. Current median graft survival among PHTx recipients ranges from 13 to 22 years. Common morbidities include infection, rejection, renal dysfunction, coronary allograft vasculopathy, and posttransplant lymphoproliferative disease. International registry data, collaborative initiatives to standardize management, and multicenter studies continue to improve knowledge and advancement of the field.
提供小儿心脏移植（PHTx）的国际视角和最新综述。
PHTx 的候补者存活率和长期预后持续改善。最大限度利用供体库的策略包括为婴儿进行 ABO 不相容列表和扩大供体与受体的体重范围。然而，国际上的实践差异很大，从列表策略和供体接受实践到慢性免疫抑制方案、长期移植物监测以及考虑再次移植。
PHTx 的常见适应证包括终末期先天性心脏病和心肌病。目前，PHTx 受者的中位移植物存活率在 13 至 22 年之间。常见的并发症包括感染、排斥、肾功能障碍、冠状动脉移植血管病和移植后淋巴组织增生性疾病。国际登记数据、旨在规范管理的合作举措以及多中心研究继续提高该领域的知识和进步。
