[AJS-03] Eight Pediatric Heart Transplantation Experiences in a Single Pediatric Heart Transplantation Center in Japan - Fifteen Years Experiences -
Keywords:小児心臓移植, VAD, 腎不全
Pediatric heart transplantation represents a small but very important part in the field of cardiac transplantation. In Japan, only after the revision of the Act in 2010, pediatric donation has been legitimated, hence very scarce number of limited pediatric heart transplantation. Despite this difficult situation, the numbers of pediatric patients referred to our hospital for the treatment of end stage heart failure were ever-increasing in recent years. In referred end-staged patients, we performed 8 pediatric heart transplantations from 1999. Among them, 4 donors were pediatric cases and 2 donors were under 6 years old, and their hearts were donated to under 10 years old patients. In their outcomes, one boy was deceased because of renal failure. Another 7 patients were good course. The waiting periods were 880 days in patients from adult donor hearts, and 362 days from pediatric donors. It was in short periods compared with the HTx from adult donors, because of the pediatric patients first policy from pediatric donor hearts and physical size of patients. However, many complications were occurred especially in patients supported with VAD. The renal dysfunction was occurred in many cases. The most recent mean creatinine level was 1.01, and BUN was 25.1. In early post heart transplantations, CHDF was needed in 3 patients. Moreover, there are still many problems to solve associated with not only donor medical treatment, such as mechanical circulation support and medicine, but also recipient and donor family support. Further enlightenment of pediatric organ donations is needed to increase pediatric heart transplantation in Japan