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Heart Transplantation—The Pediatric Cardiac Critical Care Perspective

Rossano, Joseph W. MD1; Cabrera, Antonio G. MD2; Shaddy, Robert E. MD1

Pediatric Critical Care Medicine: August 2016 - Volume 17 - Issue 8 - p S171-S177
doi: 10.1097/PCC.0000000000000813
Organ Systems: Cardiopathophysiology and Disorders

Objectives: Although there have been tremendous advancements in the care of severe pediatric cardiovascular disease, heart transplantation remains the standard therapy for end-stage heart disease in children. As such, these patients comprise an important and often complex subset of patients in the ICU. The purpose of this article is to review the causes and management of allograft dysfunction and the medications used in the transplant population.

Data Sources: MEDLINE, PubMed, and Cochrane Database of systemic reviews.

Conclusions: Pediatric heart transplant recipients represent a complex group of patients that frequently require critical care. Their immunosuppressive medications, while being vital to maintenance of allograft function, are associated with significant short- and long-term complications. Graft dysfunction can occur from a variety of etiologies at different times following transplantation and remains a major limitation to long-term posttransplant survival.

1Department of Pediatrics, Section of Cardiology, The Perelman School of Medicine at the University of Pennsylvania, The Children’s Hospital of Philadelphia, Philadelphia, PA.

2Department of Pediatrics, Section of Cardiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX.

The authors have disclosed that they do not have any potential conflicts of interest.

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Copyright © 2016 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies