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Table 13A.2. Indications for heart transplant by age group-ISHLT, 2002

Indication

Congenital Anomaly 74%

Cardiomyopathy 17%

Retransplantation 15%

1-10 yrs

11-17 yrs

Table 13A.3. Relative contraindications for pediatric cardiac transplantation

• Active Infection

• Severe Metabolic Disease

• Multiple Congenital Anomalies

• Advanced Multiple Organ Failure

• Active Malignancy respond with a reduction in their PVR prior to transplant by the administration of pulmonary vasodilators such as IV milrinone on a chronic basis pretransplant. The complete comprehensive evaluation of a child for heart transplant also includes a multidisciplinary evaluation by the renal, neurologic, infectious disease, and psychology services. Other contraindications for transplant are shown in Table 13A.3. For infants that have severe congestive heart failure not responsive to intubation, ventilation, and inotropic support, ECMO is currently the only available mechanical support. For older children over 25 kg, the Thoratec left ventricular assist device is currently available and has been used in a few centers with good results.

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