Post-heart Transplant Care and Long-Term Complications in Children

On December 3, 1967, Dr. Christiaan Barnard performed the first cardiac transplantation in Cape Town, South Africa (Buchanan E, S Afr Med J, 107(12):1041–1044, 2017). Just 3 days later, Dr. Adrian Kantrowitiz performed the first pediatric heart transplant in a 7-month old infant boy at Maimonides Medical Center in New York City (Kantrowitz A, Haller JD, Joos H, Cerruti MM, Carstensen HE, Am J Cardiol, 22(6):782–790, 1968). These pioneering efforts, and those of numerous other individuals over the next few years, marked the beginning of a new era in the treatment of heart failure. We now have five decades of experience with pediatric heart transplantation (HT) in more than 14,000 patients and have learned many important lessons about this remarkable procedure (Khush KK, Cherikh WS, Chambers DC, et al., J Heart Lung Transplant, 38(10):1056–1066, 2019). In this chapter, the authors will discuss the current state of pediatricPediatric heart transplantation HT, starting from the time of the transplantation itself. The chapter will be organized following the different phases of care, starting with the surgical procedure and continuing through the immediate postoperative care into long-term care issues. The equally important topics of patient selection and preparation, donor management, and donor allocation are addressed in a separate chapter.