Azeka Estela, Hase Fabiane, Tomimoto Yoshihiro
Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
Undergraduate School, Faculdade de Ciencias Médicas e da Saude-Pontificia Universidade Católica de São Paulo (FCMS PUC-SP), Sorocaba, SP, Brazil.
JHLT Open. 2025 Jul 21;10:100353. doi: 10.1016/j.jhlto.2025.100353. eCollection 2025 Nov.
Heart transplantation (HT) has been the treatment of choice for children with end-stage heart disease. Since the first transplant in 1967, almost 6 decades on, vast improvements have occurred, the number of transplants has increased over time, and post-transplant survival curve has progressively improved.
The purpose of this review is to analyze the current status of pediatric HT, including epidemiology of heart failure, number of ventricular assist devices, number of transplants, and outcomes. The pretransplant, contemporary issues of children with heart failure, the waiting list for transplant, the role of multidisciplinary team, perspectives to overcome the storage of donors with xenotransplantation, donation after circulatory death, and ABO-incompatible transplantation are discussed.
The outcome of transplantation in children and the main post-transplant issues related to immunosuppression, transition, and adherence were addressed, as well as the use of telemedicine as an additional tool for surveillance.
HT in pediatric population is an established treatment for end-stage heart disease patients. The survival has increased over time, and there is a promising improvement in the care of these patients in relation to quality of life based on advances in the current researches and research and innovations in the future, improving life expectancy.
心脏移植（HT）一直是终末期心脏病患儿的首选治疗方法。自1967年首次进行移植以来，近60年过去了，取得了巨大进步，移植数量随时间增加，移植后生存曲线也逐步改善。
本综述的目的是分析小儿心脏移植的现状，包括心力衰竭的流行病学、心室辅助装置的数量、移植数量和结果。讨论了移植前、当代心力衰竭患儿的问题、移植等待名单、多学科团队的作用、通过异种移植克服供体保存问题的前景、循环死亡后捐赠以及ABO血型不相容移植。
阐述了儿童移植的结果以及与免疫抑制、过渡和依从性相关的主要移植后问题，以及将远程医疗用作监测的额外工具。
小儿心脏移植是终末期心脏病患者的既定治疗方法。随着时间的推移，生存率有所提高，基于当前研究的进展以及未来的研究和创新，这些患者在生活质量方面有望得到改善，从而提高预期寿命。
