Pediatric heart transplantation: Current status and perspectives

JHLT Open Pub Date : 2025-07-21 DOI:10.1016/j.jhlto.2025.100353

Estela Azeka MD, PhD , Fabiane Hase , Yoshihiro Tomimoto

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

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儿童心脏移植：现状与展望

背景：心脏移植（HT）一直是儿童终末期心脏病的治疗选择。自1967年第一次移植以来，近60年来，已经发生了巨大的改善，移植数量随着时间的推移而增加，移植后生存曲线也逐渐改善。方法本综述的目的是分析儿童HT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。本文讨论了移植前、儿童心力衰竭的当代问题、移植等待名单、多学科团队的作用、克服异种移植供体储存的观点、循环死亡后的捐赠以及abo血型不相容的移植。结果讨论了儿童移植的结果和移植后与免疫抑制、过渡和依从性相关的主要问题，以及远程医疗作为监测的附加工具的使用。结论儿童ht治疗终末期心脏病是一种可行的治疗方法。生存率随着时间的推移而增加，根据当前研究的进展和未来的研究和创新，这些患者的生活质量有了很大的改善，延长了预期寿命。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JHLT Open

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