OBJECTIVE: Relate the characteristics of the heart transplantation in children with complex congenital heart diseases and severe cardiomyopathies. The present article was written to show the three year experience of this procedure at the Instituto do Coração HC-FMUSP. METHODS: The methodology used was based on surgical procedure in congenital heart disease, heart transplant indication criteria, inclusion criteria for donors, postoperative management, immunosupression and prophylaxis as well as treatment for potential complications. RESULTS: From November 1992 to June 1996, fourteen children, aged 12 days old to six years of age (mean: 2.2 years), underwent transplantation. Fifty-seven percent of recipients were male; weight ranged from 3.5 to 17.8 kg (mean: 10.3 kg). The mean age of donors was 4.4 years (a range of three weeks to ten years), 80% male, weight ranging from 3.8 to 20 kg (median 14.3 kg). The survival rate was 85.7% (two deaths in 14 patients). The follow-up was between one month to three years (average 16 months). The most important complications were systemic hypertension, acute rejection and infection. The number of rejections and infections per patient were 3.5 and 3.3 episodes respectively. CONCLUSIONS: In this experience heart transplantation has been giving a chance for children with complex congenital heart diseases and cardiomyopathies, with a survival rate of 85.7%.
Heart transplantation; Heart transplantation