Pediatric Heart Transplantation in Severance Hospital : 12 Year Experiences
Won Gi Woo, Yu Rim Shin, Young Hwan Park, Han Ki Park
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Background : Heart transplantation (HT) is one of the treatment options for end stage heart failure. However, because there are not many pediatric donors, there is no enough data about the pediatric patients who received heart transplantation in South Korea. Therefore, here in this article, we researched about pediatric patients who received heart transplantation in our institution.
Methods : From August, 2003 to August, 2015, there were 17 pediatric patients who received heart transplantation in our institution; we retrospectively reviewed medical records of these patients. At the time of transplantation, the mean age of patient was 14.3±2.9 years. Pre-operational EF was ranged from 10~88%, 12 patients’ EF was under 40% which means poor ventricular function.
Indications for heart transplantation were cardiomyopathy(n=10) and congenital heart disease(n=6. In addition, CHD patients had at least two previous operations before HT.
Results : After 17 pediatric heart transplantations, 1-Yr and 3-Yr survival rate was 70.6% and 63.5%. In addition, among the five patients with preoperative ECMO or VAD support, survival rate was 60%. And three patients needed ECMO after HT because of arrhythmia (V.fib and V.tac) and poor ventricular function.
Rejection episodes happened to 11 patients, but only 3 patients had rejection grade≥II by endomyocardium biopsy confirmed. For late complications, there were three episodes in infection needed admission, one in PTLD and one in CAV(cardiac allograft vasculopathy).
Conclusion : In our institution, long term survival rate for these patients was comparable to other institutions and we experienced associated complications related to infection and rejection during regular follow up.
책임저자: Han Ki Park
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Won Gi Woo, E-mail : 1keywoo@yuhs.ac