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Cardiac transplantation in a neonate—First case in Switzerland and European overview
Author(s) -
Schweiger Martin,
Stiasny Brian,
Immer Franz,
Bürki Christoph,
Schmiady Martin,
Dave Hitendu,
CavigelliBrunner Anna,
Kretschmar Oliver,
Cannizzaro Vincenzo,
Hübler Michael
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12935
Subject(s) - medicine , transplantation , heart transplantation , surgery , ventricle , intensive care medicine , cardiology
Twenty‐four percent of pediatric heart transplantations ( pHT x) are carried out in infants. Neonatal heart transplantation is both rarely performed and challenging. We report on a newborn baby girl suffering from cardiac failure due to a huge tumor (24×52 mm) within the free wall of the left ventricle ( LV ) and subtotal obstruction of the main left bronchus. Following a surgical tumor resection, a Berlin Heart EXCOR left ventricular assist device was implanted as the bridge to the transplantation. In spite of an organ donor/recipient mismatch of >200%, both heart transplantation and the postoperative course were successful. In addition to this case report, the authors also present data from a survey on performed infant and neonatal transplantations in Western Europe. As neonatal heart transplantation is a rare event in Europe, the authors think it is of crucial importance to share this limited experience. We discuss an alternative strategy—namely, palliative surgical correction using the Fontan pathway. The challenges of donor/recipient weight mismatch and the possibilities of overcoming infant donor organ shortage as a postoperative immunosuppressive regimen are discussed as well.