[I-AEPCJS-04] Outcomes of heart transplantation in children and adolescents : a Japanese single center experience
According to the International Society for Heart and Lung Transplantation (ISHLT) registry data, there are 600 to 700 cases per year of pediatric heart transplantation worldwide. In Japan, heart transplantation from pediatric donors was approved in 2010 with the revision of the law for organ donation. However, the annual number of pediatric brain death donors is very small, resulting in a waiting time of 2 to 3 years for pediatric heart transplantation. On the other hand, the post-transplant overall survival rate is favorable in Japan, even for patients who have undergone heart transplantation in the USA and Europe.Osaka University Hospital is one of the six pediatric heart transplant centers in Japan. Since 2012, we have conducted 38 cases of pediatric (< 18 years old) heart transplantation, accounting for approximately half of the cases in Japan. As of April 2023, we have managed 76 patients who underwent heart transplantation before the age of 20, including 41 cases transplanted in Japan and 35 cases transplanted in other countries. The 5-, 10-, and 15-year overall survival rates were 92%, 92%, and 85%, respectively. In comparison to ISHLT data, the patients managed at Osaka University, who received transplantation in the USA or Europe then came back to Japan, also exhibited better survival rates; 5-, 10-, and 15-year survival rates were 89%, 89%, and 84%, respectively.However, we have encountered several severe complications after transplantation, including twelve cases of PTLD. In this session, I will present an overview of post-transplant outcomes at Osaka University Hospital, as well as future perspectives for the therapeutic strategy of severe heart failure, including regenerative medicines.