Kim Young Hwue
Department of Pediatric Cardiology, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Clin Exp Pediatr. 2021 Feb;64(2):49-59. doi: 10.3345/cep.2019.01417. Epub 2020 Apr 8.
Since the initial International Society of Heart Lung Transplantation registry was published in 1982, the number of pediatric heart transplantations has increased markedly, reaching a steady state of 500-550 transplantation annually and occupying up to 10% of total heart transplantations. Heart transplantation is considered an established therapeutic option for patients with end-stage heart disease. The long-term outcomes of pediatric heart transplantations were comparable to those of adults. Issues affecting long-term outcomes include acute cellular rejection, antibody-mediated rejection, cardiac allograft vasculopathy, infection, prolonged renal dysfunction, and malignancies such as posttransplant lymphoproliferative disorder. This article focuses on medical issues before pediatric heart transplantation, according to the Korean Network of Organ Sharing registry and as well as major problems such as graft rejection and cardiac allograft vasculopathy. To reduce graft failure rate and improve long-term outcomes, meticulous monitoring for rejection and medication compliance are also important, especially in adolescents.
自1982年国际心肺移植学会首次发布登记数据以来，小儿心脏移植的数量显著增加，每年稳定在500 - 550例，占心脏移植总数的10%。心脏移植被认为是终末期心脏病患者的一种既定治疗选择。小儿心脏移植的长期结果与成人相当。影响长期结果的问题包括急性细胞排斥、抗体介导的排斥、心脏移植血管病变、感染、长期肾功能不全以及移植后淋巴增生性疾病等恶性肿瘤。本文根据韩国器官共享网络登记处的数据，重点探讨小儿心脏移植前的医学问题，以及移植物排斥和心脏移植血管病变等主要问题。为降低移植物失败率并改善长期结果，对排斥反应进行细致监测和确保药物依从性也很重要，尤其是在青少年患者中。
