Document Detail


Cardiac transplantation in adults with congenital heart disease.
MedLine Citation:
PMID:  20639237     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Due to increasing success with repair or palliation in childhood, there is a rapidly growing population of adult patients with complex congenital heart disease who may require transplantation. There remains little data on outcomes of cardiac transplantation in this group. METHODS: 38 orthotopic cardiac transplants were performed in 37 patients (18 men) > or =18 years of age with congenital heart disease (CHD) from 1988 to 2009 in our institution. Outcomes were reviewed using medical records and transplant databases. RESULTS: 15 patients (41%) had univentricular and 22 (59%) biventricular physiology. The biggest group was transposition of the great arteries following atrial switch in eight patients (22%). Six (16%) had no previous surgical intervention. Mean age at transplant was 33.5 years (range 19.1-59.9 years). 11 patients (30%) required additional surgical procedures at transplant. 16 (43%) died, 12 early and 4 late deaths (1.8, 2.4, 2.7 and 7 years). Survival was 70% at 30 days, 68% at 1 year, 58% at 5 years and 53% at 10 and 15 years. Outcome improved in later eras with reduction in 30-day mortality from 50% to 18% and increase in 5-year survival from 50% to 69%. Two patients developed post-transplant lymphoproliferative disease. None required long-term renal replacement therapy. One patient was re-transplanted for cardiac allograft vasculopathy. CONCLUSIONS: While operative mortality following cardiac transplantation for adult congenital heart disease is higher than for other diagnostic groups, long-term survival is good and comparable to patients without CHD. Disappointing early results are improved with increasing experience.
Authors:
C Irving; G Parry; J O'Sullivan; J H Dark; R Kirk; D S Crossland; M Chaudhari; M Griselli; J R L Hamilton; A Hasan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1217-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatric Cardiology, Freeman Hospital, Newcastle upon, UK. claire.irving@nuth.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Cause of Death
Female
Heart Defects, Congenital / diagnosis,  surgery*
Heart Transplantation*
Humans
Immunosuppression / methods
Male
Middle Aged
Patient Selection
Postoperative Care / methods
Prognosis
Reoperation
Survival Analysis
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
Heart. 2010 Aug;96(15):1172-3   [PMID:  20639233 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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