[ISPHLT-KL1] The world of pediatric heart transplantation from the beginning
In pediatrics we have never been able to accept that the death of a child was inevitable. Physicians over the years have tried experimental treatments in order to try to save those children on death's door, and families have been willing participants. For children with congenital heart disease physicians began pushing boundaries in 1938 with ligation of a ductus and in 1944 with creation of a Blalock-Taussig shunt. This was quickly followed by complex intracardiac procedures starting in the 1950's that would save children with even complex congenital heart disease. And so it was that in 1967, just 3 days after Dr Christian Barnard performed the world's first heart transplant in an adult, Dr Adrian Kantrowitz in New York attempted a heart transplant in a dying newborn using a donor from an anencephalic baby. He would never have been able to perform this operation in this day and age. The infant died just 6 hours after the procedure, but the seeds were planted for the rise of pediatric heart transplantation. However, the world would have to wait longer for heart transplantation to be offered again to small children, until the complex care and immunosuppressive therapy necessary for patients to survive had improved enough such that saving a child's life with transplantation would provide them with a good quality lifestyle and the chance for growing up. We will discuss the pioneers in this field over the past 50 years, and the key moments that have allowed our field to progress to where it is today, that children who undergo heart transplantation can expect to grow up, pursue their dreams and have families of their own.