Our Summary

This paper discusses heart transplants in children who suffer from heart failure and aren’t responsive to other treatments. Heart transplants are given in cases of congenital heart diseases that can’t be repaired or have failed to improve with other treatments, and cardiomyopathies (diseases of the heart muscle). The field has seen major advancements since the first heart transplant in 1967. Around 500 heart transplants are performed on children worldwide each year. Children who have undergone heart transplants are living longer with their new hearts. Many pediatric doctors are involved in the care of these children before and after their transplants, so they need to understand the basics of heart transplantation. There are certain complications and considerations unique to this group, including medication side effects, management of fever-related illnesses, opportunistic infections, vaccination, pregnancy, and exercise recommendations.

FAQs

  1. When is a heart transplant considered for children?
  2. What are some complications and considerations for children who have undergone heart transplants?
  3. How many heart transplants are performed on children worldwide each year?

Doctor’s Tip

One important tip that a doctor might give a patient about heart transplant is to closely follow the medication regimen prescribed by their healthcare team. These medications are essential for preventing rejection of the new heart and ensuring its long-term function. It is important to take the medications as directed, attend all follow-up appointments, and communicate any concerns or changes in health to the healthcare team promptly. Additionally, maintaining a healthy lifestyle with regular exercise, a balanced diet, and avoiding smoking or excessive alcohol consumption can help support the success of the transplant.

Suitable For

Patients who are typically recommended for heart transplants are those who suffer from severe heart failure and have not responded to other treatments. This includes patients with congenital heart diseases that cannot be repaired or have failed to improve with other treatments, as well as patients with cardiomyopathies. Heart transplants are considered as a last resort option for these patients when other treatment options have been exhausted. It is important for pediatric doctors to be familiar with the basics of heart transplantation and the unique considerations and complications that come with caring for children who have undergone heart transplants.

Timeline

Before a heart transplant:

  • A child is diagnosed with a severe heart condition that cannot be treated effectively with other methods.
  • The child undergoes a thorough evaluation by a transplant team to determine if they are a suitable candidate for a heart transplant.
  • The child is placed on a waiting list for a suitable donor heart, which can take weeks to months.
  • While waiting, the child may need to undergo various tests, treatments, and therapies to manage their condition and keep them stable.

After a heart transplant:

  • The child undergoes the heart transplant surgery, which can last several hours.
  • The child is closely monitored in the intensive care unit (ICU) immediately after the surgery to ensure the new heart is functioning properly.
  • The child may stay in the hospital for several weeks to recover and receive post-transplant care.
  • The child will need to take immunosuppressive medications for the rest of their life to prevent rejection of the new heart.
  • The child will have regular follow-up appointments with their transplant team to monitor their progress, adjust medications, and address any complications that may arise.
  • The child will need to make lifestyle changes, such as avoiding certain activities and following a strict medication regimen, to maintain the health of their new heart.

Overall, a heart transplant is a life-changing procedure that can greatly improve the quality of life for children with severe heart conditions. With proper care and monitoring, many children who undergo heart transplants go on to live long and fulfilling lives.

What to Ask Your Doctor

  1. What are the risks and benefits of a heart transplant for my child?

  2. How long is the waiting list for a heart transplant for children?

  3. What criteria need to be met for my child to be eligible for a heart transplant?

  4. What is the recovery process like after a heart transplant for children?

  5. What medications will my child need to take after a heart transplant and what are the potential side effects?

  6. How often will my child need to follow up with their medical team after a heart transplant?

  7. What lifestyle changes will my child need to make after a heart transplant?

  8. Are there any restrictions on physical activity or diet for children who have had a heart transplant?

  9. What signs or symptoms should I watch for that may indicate rejection or other complications after a heart transplant?

  10. How long can my child expect their new heart to last and what is the long-term prognosis for children who have had a heart transplant?

Reference

Authors: Sehgal S, Shea E, Kelm L, Kamat D. Journal: Pediatr Ann. 2018 Apr 1;47(4):e172-e178. doi: 10.3928/19382359-20180319-01. PMID: 29668027