Ten-Year Pediatric Heart Transplantation: Insights and Outcomes From a Leading Center in Iran.

Abstract

Introduction: Heart transplantation is the definitive treatment for infants and children with nine advanced stages of congenital heart failure. This study presents the experiences of a single medical center regarding pediatric heart transplants conducted over a decade.

Methods: Baseline characteristics of recipients and donors of pediatric heart transplant patients from 2012 to 2021 were recorded. Post-transplant complications and survival rates were assessed during a median follow-up period of 2 years.

Results: The study, which spanned a decade and included 225 transplants, revealed several key findings. The mean age of recipients was 10.8 years, with a majority being boys. The most common diagnoses were dilated cardiomyopathy (83.6%) and restrictive cardiomyopathy (8.0%). Donors, with a mean age of 21.4 years, were predominantly male. The primary causes of donor death were head trauma/motor vehicle accidents (56.9%). Notably, post-transplant complications included Renal failure requiring dialysis (15.7%), Central Nervous System (16.9%), Cytomegalovirus infections (24.9%), and Epstein-Barr virus infections (21.8%). During the follow-up, 48 deaths were recorded, yielding a crude mortality rate of 7.4 per 100 person-years. The 1-year, 3-year, and 5-year survival rates, which were 85.7%, 79.7%, and 73.9%, respectively, demonstrate the significant progress in pediatric heart transplant outcomes over the past decade.

Conclusion: Pediatric heart transplant outcomes have improved over the past decade, although challenges remain. Significant risk factors for mortality include donor age, male donor gender, and 28 Rituximab treatment. Strategies to mitigate these risks could enhance survival rates post-transplant.