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Pediatric Transplantation



















                           THE FIRST SUCCESSFUL PEDIATRIC HEART TRANSPLANT
                                      AND RESULTS FROM THE EARLIEST ERA


                                    Journal: Pediatric Transplantation

                               Manuscript ID Draft
                            Manuscript Type: Registry Report

                       Date Submitted by the   n/a
                                    Author:
                     Complete List of Authors: Kirk, Richard; UTSW, Pediatric Cardiology
                                             Butts, Ryan; Children's Health Children's Medical Center Dallas, ;
                                             University of Texas Southwestern Department of Pediatrics,
                                             Dipchand, Anne; Hospital for Sick Children, Labatt Family Heart Centre

                                  Keywords: heart transplant, pediatric, first, outcomes
                                             Background
                                             The first pediatric heart transplant died five hours after transplant and
                                             the case was published by Kantrowitz. There is no report of the first
                                             successful case in the medical literature, nor indeed the outcome of
                                             children transplanted prior to 1982. However we recently discovered that
                                             children from this period were entered retrospectively into the ISHLT
                                             Registry when it began and they form the basis of this report.
                                             Methods
                                             A retrospective review of the ISHLT thoracic registry was undertaken for
                                             pediatric heart transplants prior to 1982. Demographic and descriptive
                                             data, patient and graft survival were analyzed.
                                        For Peer Review
                                             Results
                                             Thirty children (24 male) had a median age of 13 years (IQR 12-16) at
                                   Abstract:
                                             time of primary transplant. The underlying cardiac diagnosis was
                                             cardiomyopathy (18), congenital heart disease (7), not reported (5). The
                                             median follow-up was 2.63 years. (IQR 0.1-7.2). Twenty-two are known
                                             to have died, eight underwent retransplantation. Median patient survival
                                             was 3.5 years. The first patient to survive for more than one year was
                                             transplanted in 1968 and survived 6 years.
                                             Conclusion
                                             The definition of a successful transplant is debatable however the first
                                             child reported to the registry to survive beyond one year was
                                             transplanted in 1968. Survival for these early patients was considerably
                                             less than the subsequent eras and retransplantation more common,
                                             however the experience managing these children laid the foundation for
                                             the future.











                               The official publication of the International Pediatric Transplant Association
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