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First two decades of paediatric heart transplantation in Sweden – outcome of listing and post‐transplant results
Author(s) -
Gilljam Thomas,
Higgins Thomas,
Bennhagen Rolf,
Wåhlander Håkan
Publication year - 2011
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2011.02377.x
Subject(s) - medicine , transplantation , heart transplantation , pediatrics , population , retrospective cohort study , coronary artery disease , cardiomyopathy , surgery , heart disease , heart failure , environmental health
Aims: To evaluate outcome in the first generation of children with end‐stage heart disease to whom heart transplantation was available. Methods: Retrospective review of all 135 Swedish children <18 years old listed for heart transplantation 1989–2009, followed to December 31, 2009, including 74 (55%) with cardiomyopathy and 61 (45%) with congenital heart disease; 34 (25%) were infants (<1 year). Cumulative risk of requiring heart transplantation was 1:17 300 (11 patients who improved were omitted from outcome analysis). Results: Waiting‐list mortality was 31% (44% in infants). Median waiting time in 82 transplanted patients was 57 days (0–585 days). Post‐transplant follow‐up time was median 5.9 years (0.03–20.1 years), and actuarial survival was 92% at 1 year, 82% at 5 years, 76% at 10 years and 58% at 15 years. Survival after listing was 64% at 1 year, 58% at 5 years, 52% at 10 years and 40% at 15 years. Post‐transplant complications included rejections (34%), malignancies (12%), renal failure (8%), coronary artery vasculopathy (6%) and re‐transplantation (5%). Among 64 survivors, 84% were free of complications affecting prognosis. Conclusion: High waiting‐list mortality and post‐transplant attrition precluded 60% of this pioneer population from reaching adulthood. Functional status in survivors is generally good.