Heart Transplantation

PediatricPediatric heart transplantationHeart transplantation is the treatment of choice for childrenChildren with end-stage heart diseaseHeart transplantation. For patients who are carefully selected through the transplant evaluation process, transplantation offers an improved survivalSurvival and quality of life. This chapter reviews the indications for transplantation, transplant candidacy and the pre transplant evaluation process including the investigations and evaluations involved. The unique concept of ABO incompatible transplant in the pediatricPediatric population is introduced. The process for transplant listing, waitlist mortality along with strategies to optimize medical and psychosocial needs as patients wait are discussed. As part of the surgical strategy, donor considerations are reviewed along with induction immunosuppressionImmunosuppression alongside intensive care support. Finally post-transplant surveillance and monitoring for rejection and cardiac allograft vasculopathy along with screening for common co morbidities such as renal insufficiency, infection and post-transplant lymphoproliferative diseaseWaiting list are reviewed. Long term outcomes for transplant are put forward.