Current status of cardiac transplantation in children.

Advancements in surgical techniques, myocardial preservation, and immunosuppression have resulted in dramatic improvements in the survival and quality of life for the pediatric cardiac transplant recipient. Transplantation can now be extended with equal success to a broader range of congenital as well as acquired heart lesions. Challenges remain to find more selective immunosuppression strategies, which should reduce the frequency of limiting late complications such as graft coronary disease or posttransplantation lymphoproliferative disease. In addition, continued progress is necessary to find new noninvasive methods for detecting rejection and coronary disease, which will further enhance the quality of life for children.