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A contemporary review of paediatric heart transplantation and mechanical circulatory support

Published online by Cambridge University Press:  16 March 2016

Steven J. Kindel
Affiliation:
Department of Pediatric Cardiology, Children’s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
Melanie D. Everitt*
Affiliation:
Heart Institute, Children’s Hospital Colorado, University of Colorado, Aurora, Colorado, United States of America
*
Correspondence to: M. D. Everitt, MD, Children’s Hospital Colorado, 13123 East 16th Avenue, Aurora, CO 80045, United States of America. Tel: +720 777 3218; Fax: 720 777 7892; E-mail: melanie.everitt@childrenscolorado.org

Abstract

Improvements in the care of children with cardiomyopathy, CHDs, and acquired heart disease have led to an increased number of children surviving with advanced heart failure. In addition, the advent of more durable mechanical circulatory support options in children has changed the outcome for many patients who otherwise would have succumbed while waiting for heart transplantation. As a result, more children with end-stage heart failure are being referred for heart transplantation, and there is increased demand for a limited donor organ supply. A review of important publications in the recent years related to paediatric heart failure, transplantation, and mechanical circulatory support show a trend towards pushing the limits of the current therapies to address the needs of this growing population. There have been a number of publications focussing on previously published risk factors perceived as barriers to successful heart transplantation, including elevated pulmonary vascular resistance, medication non-adherence, re-transplantation, transplantation of the failed Fontan patient, and transplantation in an infant or child bridged with mechanical circulatory support. This review will highlight some of these key articles from the last 3 years and describe recent advances in the understanding, diagnosis, and management of children with end-stage heart disease.

Type
Review Articles
Copyright
© Cambridge University Press 2016 

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References

1. Bailey, LL. The evolution of infant heart transplantation. J Heart Lung Transplant 2009; 28: 12411245.CrossRefGoogle ScholarPubMed
2. Dipchand, AI, Edwards, LB, Kucheryavaya, AY, et al. The registry of the International Society for Heart and Lung Transplantation: seventeenth official pediatric heart transplantation report-2014; focus theme: retransplantation. J Heart Lung Transplant 2014; 33: 985995.CrossRefGoogle ScholarPubMed
3. Kirk, R, Dipchand, A, Rosenthal, D. ISHLT Guidelines for the Management of Pediatric Heart Failure. University of Alabama at Birmingham Division of Cardiothoracic Surgery, Birmingham, Alabama, 2014.Google Scholar
4. Rossano, JW, Kim, JJ, Decker, JA, et al. Prevalence, morbidity, and mortality of heart failure-related hospitalizations in children in the United States: a population-based study. J Card Fail 2012; 18: 459470.CrossRefGoogle ScholarPubMed
5. Shamszad, P, Hall, M, Rossano, JW, et al. Characteristics and outcomes of heart failure-related intensive care unit admissions in children with cardiomyopathy. J Card Fail 2013; 19: 672677.CrossRefGoogle ScholarPubMed
6. Rodriguez, FH 3rd, Moodie, DS, Parekh, DR, et al. Outcomes of heart failure-related hospitalization in adults with congenital heart disease in the United States. Congenit Heart Dis 2013; 8: 513519.Google Scholar
7. Alexander, PM, Daubeney, PE, Nugent, AW, et al. Long-term outcomes of dilated cardiomyopathy diagnosed during childhood: results from a national population-based study of childhood cardiomyopathy. Circulation 2013; 128: 20392046.Google Scholar
8. Everitt, MD, Sleeper, LA, Lu, M, et al. Recovery of echocardiographic function in children with idiopathic dilated cardiomyopathy: results from the pediatric cardiomyopathy registry. J Am Coll Cardiol 2014; 63: 14051413.CrossRefGoogle ScholarPubMed
9. Molina, KM, Shrader, P, Colan, SD, et al. Predictors of disease progression in pediatric dilated cardiomyopathy. Circ Heart Failure 2013; 6: 12141222.Google Scholar
10. Almond, CS, Gauvreau, K, Thiagarajan, RR, et al. Impact of ABO-incompatible listing on wait-list outcomes among infants listed for heart transplantation in the United States: a propensity analysis. Circulation 2010; 121: 19261933.Google Scholar
11. Davies, RR, Haldeman, S, Pizarro, C. Regional variation in survival before and after pediatric heart transplantation – an analysis of the UNOS database. Am J Transplant 2013; 13: 18171829.CrossRefGoogle ScholarPubMed
12. Alsoufi, B, Mahle, WT, Manlhiot, C, et al. Outcomes of heart transplantation in children with hypoplastic left heart syndrome previously palliated with the Norwood procedure. J Cardiovasc Surg 2016; 151: 167175.Google ScholarPubMed
13 Cassidy, J, Dominguez, T, Haynes, S, et al. A longer waiting game: bridging children to heart transplant with the Berlin Heart EXCOR device – the United Kingdom experience. J Heart Lung Transplant. 2013; 32: 11011106.CrossRefGoogle ScholarPubMed
14. Singh, TP, Almond, CS, Piercey, G, Gauvreau, K. Risk stratification and transplant benefit in children listed for heart transplant in the United States. Circ Heart Fail 2013; 6: 800808.CrossRefGoogle ScholarPubMed
15. Jeewa, A, Manlhiot, C, Kantor, PF, Mital, S, McCrindle, BW, Dipchand, AI. Risk factors for mortality or delisting of patients from the pediatric heart transplant waiting list. J Thorac Cardiovasc Surg 2014; 147: 462468.Google Scholar
16. Oliva, M, Singh, TP, Gauvreau, K, Vanderpluym, CJ, Bastardi, HJ, Almond, CS. Impact of medication non-adherence on survival after pediatric heart transplantation in the U.S.A. J Heart Lung Transplant 2013; 32: 881888.Google Scholar
17. Savla, J, Lin, KY, Lefkowitz, DS, et al. Adolescent age and heart transplantation outcomes in myocarditis or congenital heart disease. J Heart Lung Transplant 2014; 33: 943949.CrossRefGoogle ScholarPubMed
18. Conway, J, Manlhiot, C, Kirk, R, Edwards, LB, McCrindle, BW, Dipchand, AI. Mortality and morbidity after retransplantation after primary heart transplant in childhood: an analysis from the registry of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2014; 33: 241251.CrossRefGoogle ScholarPubMed
19. Friedland-Little, JM, Gajarski, RJ, Yu, S, Donohue, JE, Zamberlan, MC, Schumacher, KR. Outcomes of third heart transplants in pediatric and young adult patients: analysis of the United Network for Organ Sharing database. J Heart Lung Transplant 2014; 33: 917923.Google Scholar
20. Richmond, ME, Law, YM, Das, BB, et al. Elevated pre-transplant pulmonary vascular resistance is not associated with mortality in children without congenital heart disease: a multicenter study. J Heart Lung Transplant 2015; 34: 448456.CrossRefGoogle Scholar
21. Bernstein, D, Naftel, D, Chin, C, et al. Outcome of listing for cardiac transplantation for failed Fontan: a multi-institutional study. Circulation 2006; 114: 273280.CrossRefGoogle Scholar
22. Lamour, JM, Kanter, KR, Naftel, DC, et al. The effect of age, diagnosis, and previous surgery in children and adults undergoing heart transplantation for congenital heart disease. J Am Coll Cardiol 2009; 54: 160165.CrossRefGoogle ScholarPubMed
23. Backer, CL, Russell, HM, Pahl, E, et al. Heart transplantation for the failing Fontan. Ann Thorac Surg 2013; 96: 14131419.CrossRefGoogle ScholarPubMed
24. Michielon, G, van Melle, JP, Wolff, D, et al. Favourable mid-term outcome after heart transplantation for late Fontan failure. Eur J Cardiothorac Surg 2015; 47: 665671.Google Scholar
25. Ghaferi, AA, Hutchins, GM. Progression of liver pathology in patients undergoing the Fontan procedure: chronic passive congestion, cardiac cirrhosis, hepatic adenoma, and hepatocellular carcinoma. J Thorac Cardiovasc Surg 2005; 129: 13481352.Google Scholar
26. Kiesewetter, CH, Sheron, N, Vettukattill, JJ, et al. Hepatic changes in the failing Fontan circulation. Heart 2007; 93: 579584.Google Scholar
27. Kendall, TJ, Stedman, B, Hacking, N, et al. Hepatic fibrosis and cirrhosis in the Fontan circulation: a detailed morphological study. J Clin Pathol 2008; 61: 504508.CrossRefGoogle ScholarPubMed
28. Schwartz, MC, Sullivan, L, Cohen, MS, et al. Hepatic pathology may develop before the Fontan operation in children with functional single ventricle: an autopsy study. J Thorac Cardiovasc Surg 2012; 143: 904909.CrossRefGoogle ScholarPubMed
29. Wallihan, DB, Podberesky, DJ. Hepatic pathology after Fontan palliation: spectrum of imaging findings. Pediatr Radiol 2013; 43: 330338.Google Scholar
30. Simpson, KE, Esmaeeli, A, Khanna, G, et al. Liver cirrhosis in Fontan patients does not affect 1-year post-heart transplant mortality or markers of liver function. J Heart Lung Transplant 2014; 33: 170177.CrossRefGoogle ScholarPubMed
31. Hollander, SA, Reinhartz, O, Maeda, K, Hurwitz, M, N Rosenthal, D, Bernstein, D. Intermediate-term outcomes after combined heart-liver transplantation in children with a univentricular heart. J Heart Lung Transplant 2013; 32: 368370.CrossRefGoogle ScholarPubMed
32. Warnecke, H, Berdjis, F, Hennig, E, et al. Mechanical left ventricular support as a bridge to cardiac transplantation in childhood. Eur J Cardiothorac Surg 1991; 5: 330333.Google Scholar
33. Kirklin, JK, Naftel, DC, Pagani, FD, et al. Sixth INTERMACS Annual report: a 10,000-patient database. J Heart Lung Transplant 2014; 33: 555564.CrossRefGoogle ScholarPubMed
34. Almond, CS, Morales, DL, Blackstone, EH, et al. Berlin Heart EXCOR pediatric ventricular assist device for bridge to heart transplantation in US children. Circulation 2013; 127: 17021711.CrossRefGoogle ScholarPubMed
35. Eghtesady, P, Almond, CS, Tjossem, C, et al. Post-transplant outcomes of children bridged to transplant with the Berlin Heart EXCOR pediatric ventricular assist device. Circulation 2013; 128: S24S31.Google Scholar
36. Byrnes, JW, Prodhan, P, Williams, BA, et al. Incremental reduction in the incidence of stroke in children supported with the Berlin EXCOR ventricular assist device. Ann Thorac Surg 2013; 96: 17271733.CrossRefGoogle ScholarPubMed
37. Miera, O, Schmitt, KR, Delmo-Walter, E, Ovroutski, S, Hetzer, R, Berger, F. Pump size of Berlin Heart EXCOR pediatric device influences clinical outcome in children. J Heart Lung Transplant 2014; 33: 816821.Google Scholar
38. Cabrera, AG, Sundareswaran, KS, Samayoa, AX, et al. Outcomes of pediatric patients supported by the HeartMate II left ventricular assist device in the United States. J Heart Lung Transplant 2013; 32: 11071113.CrossRefGoogle ScholarPubMed
39. Crews, KA, Kaiser, SL, Walczak, RJ, Jaquiss, RD, Lodge, AJ. Bridge to transplant with extracorporeal membrane oxygenation followed by HeartWare ventricular assist device in a child. Ann Thorac Surg 2013; 95: 17801782.Google Scholar
40. T Kulat, B, Russell, HM, Sarwark, AE, et al. Modified tandemheart ventricular assist device for infant and pediatric circulatory support. Ann Thorac Surg 2014; 98: 14371441.Google Scholar
41. Filippelli, S, Perri, G, Kirk, R, Griselli, M, Hasan, A. Successful pediatric orthotopic heart transplantation after three runs of mechanical circulatory support. Ann Thorac Surg 2013; 95: 21762178.Google Scholar
42. Yilmaz, B, Zuckerman, WA, Lee, TM, et al. Left ventricular assist device to avoid heart-lung transplant in an adolescent with dilated cardiomyopathy and severely elevated pulmonary vascular resistance. Pediatr Transplant 2013; 17: E113E116.CrossRefGoogle Scholar
43. Irving, CA, Crossland, DS, Haynes, S, Griselli, M, Hasan, A, Kirk, R. Evolving experience with explantation from Berlin Heart EXCOR ventricular assist device support in children. J Heart Lung Transplant 2014; 33: 211213.Google Scholar
44. Sparks, J, Epstein, D, Baltagi, S, et al. Continuous flow device support in children using the HeartWare HVAD: 1000 days of lessons learned from a single center experience. ASAIO J 2015; 61: 569573.Google Scholar
45. Ferro, G, Murthy, R, Williams, D, Sebastian, VA, Forbess, JM, Guleserian, KJ. Early outcomes with HeartWare HVAD as bridge to transplant in children a single institution experience. Artif Organs 2016; 40: 8589.Google Scholar
46. Stein, ML, Bruno, JL, Konopacki, KL, Kesler, S, Reinhartz, O, Rosenthal, D. Cognitive outcomes in pediatric heart transplant recipients bridged to transplantation with ventricular assist devices. J Heart Lung Transplant 2013; 32: 212220.Google Scholar
47. Ezon, DS, Khan, MS, Adachi, I, et al. Pediatric ventricular assist device use as a bridge to transplantation does not affect long-term quality of life. J Thorac Cardiovasc Surg 2014; 147: 13341343.Google Scholar