Nav: Home

Heart transplantation for adult CHD: Overview and special considerations

June 10, 2018

In the current issue of Cardiovascular Innovations and Applications (Volume3, Number 1, 2018, pp. pp. 73-84(12); DOI: 10.15212/CVIA.2017.0043, Dipankar Gupta, Jana Reid, Diego Moguillansky, Renata Shih, Mark S. Bleiweis, Frederick J. Fricker and Biagio A. Pietra from the Congenital Heart Center, Department of Pediatrics, UF Health Shands Children's Hospital, University of Florida, Gainesville, FL, USA consider how with improvements in surgical and medical management, the number of patients with congenital heart disease (CHD) reaching adulthood has increased over the last decade.

Success in the management of congenital heart disease (CHD) in the young is leading to an increasing number of heart transplants in adults with CHD. CHD has an incidence of 0.8-1%, translating to approximately 40,000 newborns per year. With improving surgical and interventional techniques and medical management, approximately 90% of children with CHD survive to adulthood. On the basis of a recent study, there are approximately 2.4 million people in the United States with CHD. On the basis of this study, the estimated number of adults with CHD in the United States is approximately 1.4 million. The population of adults with CHD in 2010 demonstrated a 63% increase when compared with the estimates from 2000, making it the fastest growing population in congenital cardiology. In addition, approximately 300,000 patients of the 1.4 million adults with CHD have evidence of severe CHDs. Adult CHD (ACHD) is associated with multiple morbidities secondary to the original anatomic substrate, multiple palliative procedures, and associated complications. Unfortunately, despite improved surgical and medical management, approximately 10-20% patients with CHD progress to end-stage heart failure as adults, and it is the most common cause of late death in patients with ACHD.

The cohort of ACHD patients is increasing significantly. There is a high likelihood for the need for heart transplantation as these patients develop chronic heart failure and other chronic sequelae of palliated CHD. It is important to recognize advanced heart failure and other associated complications early in this cohort of complex patients for early referral to an ACHD specialist. Because of the presence of multiple factors that can affect the long-term outcomes, there needs to be a careful selection process for transplantation to optimize the utilization of donor organs. Our experience with transplantation in ACHD patients demonstrates excellent short-term outcomes; however, the timing of transplantation is a huge challenge, mostly related to other end-organ dysfunction. Further studies are needed to continue to improve the outcomes after transplantation.
-end-
CVIA is available on the IngentaConnect platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information)

Cardiovascular Innovations and Applications

Related Congenital Heart Disease Articles:

Genes responsible for severe congenital heart disease identified by Pitt researcher
Genes responsible for hypoplastic left heart syndrome identified using mouse models.
Ablation for atrial fibrillation proven safe and effective for patients with congenital heart disease, Penn study finds
In a new study presented today at the Heart Rhythm Society's 38th Annual Scientific Session in Chicago, researchers from the Perelman School of Medicine at the University of Pennsylvania have found that CHD patients -- even with complex defects -- can safely undergo ablation for AF, with similar success rates as patients with normal hearts.
Lessening radiation risk for children with congenital and acquired heart disease
Newly released recommendations for pediatric radiation safety will be discussed during the Society for Cardiovascular Angiography and Interventions (SCAI) 2017 Scientific Sessions in New Orleans.
High-throughput, in vivo validation of candidate congenital heart disease genes
Specific genetic errors that trigger congenital heart disease in humans can be reproduced reliably in Drosophila melanogaster -- the common fruit fly -- an initial step toward personalized therapies for patients in the future.
Women with high-risk congenital heart disease can have successful pregnancies
Women with high-risk congenital heart disease can have successful pregnancies but should seek counseling before conception to understand how their conditions could affect pregnancy and their child's health.
First US babies treated in study of adult stem cell therapy for congenital heart disease
In a first-in-children randomized clinical study, medical researchers at the University of Maryland School of Medicine (UM SOM) and the Interdisciplinary Stem Cell Institute (ISCI) at the University of Miami Miller School of Medicine have begun testing to see whether adult stem cells derived from bone marrow benefit children with the congenital heart defect hypoplastic left heart syndrome (HLHS).
Children dying preventable deaths from congenital heart disease
Over one million children are born with congenital heart disease (CHD) each year, and 90 percent are born in poor regions with little or no access to care.
Einstein scientist receives $7.5 million grant for congenital heart disease research
The National Institutes of Health has awarded Bernice Morrow, Ph.D., at Albert Einstein College of Medicine and collaborators at the Children's Hospital of Philadelphia a five-year, $7.5 million grant to study the genetics of congenital heart abnormalities.
Mother's blood sugar measurement associated with baby's congenital heart disease risk
For the first time, researchers have shown that the level of blood sugar measured in the first trimester of pregnancy may be associated with the risk of delivering a baby with congenital heart disease, according to a preliminary study presented at the American Heart Association's Scientific Sessions 2016.
Women with congenital heart disease have better shot at healthy pregnancies
New research from the Perelman School of Medicine at the University of Pennsylvania reveals that women with CHD who are deemed high risk by conventional measures are more likely to have safe, healthy pregnancies than current risk-assessments suggest.

Related Congenital Heart Disease Reading:

Illustrated Field Guide to Congenital Heart Disease and Repair - Pocket Sized
by Allen D. Everett (Author), D. Scott, M.D. Lim (Author), Paul Burns (Illustrator), Jasper Burns (Illustrator), Marcia L. Buck (Illustrator), Jane E., M.D. Crosson (Illustrator)

Diagnosis and Management of Adult Congenital Heart Disease
by Michael A. Gatzoulis MD PhD FACC FESC (Author), Gary D. Webb MD CM FACC (Author), Piers E. F. Daubeney DM FRCP FRCPCH (Author)

Comprehensive Surgical Management of Congenital Heart Disease
by Richard A Jonas (Author)

Heart: A History
by Sandeep Jauhar (Author)

Congenital Heart Disease: A Surgical Color Atlas
by A. Sukru Mercan (Author), Zakariya Hubail (Author), S. Yen Ho (Author)

Echocardiography in Pediatric and Congenital Heart Disease: From Fetus to Adult
by Wyman W. Lai (Author), Luc L. Mertens (Author), Meryl S. Cohen (Author), Tal Geva (Author)

Atlas of Congenital Heart Disease Nomenclature: An Illustrated Guide to the Van Praagh and Anderson Approaches to Describing Congenital Cardiac Pathology
by David S. Ezon MD (Author), Jason F. Goldberg MD (Author), William B. Kyle MD (Author)

Congenital Diseases of the Heart: Clinical-Physiological Considerations
by Abraham Rudolph (Author)

Illustrated Field Guide to Congenital Heart Disease and Repair - Large Format
by Allen D. Everett (Author), D. Scott, M.D. Lim (Author), Marcia L. Buck (Author), Jasper Burns (Editor), Paul Burns (Editor)

Congenital Heart Disease: The Catheterization Manual
by Lisa Bergersen (Editor), Susan Foerster (Editor), Audrey C. Marshall (Editor), Jeffery Meadows (Editor)

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Hacking The Law
We have a vision of justice as blind, impartial, and fair — but in reality, the law often fails those who need it most. This hour, TED speakers explore radical ways to change the legal system. Guests include lawyer and social justice advocate Robin Steinberg, animal rights lawyer Steven Wise, political activist Brett Hennig, and lawyer and social entrepreneur Vivek Maru.
Now Playing: Science for the People

#496 Anti-Intellectualism: Down With the Scientist!
This week we get to the bottom of anti-intellectualism. We'll be speaking with David Robson, senior journalist at BBC Future, about misology -- the hatred of reason and argument -- and how it may be connected to distrust of intellectuals. Then we'll speak with Bruno Takahashi, associate professor of environmental journalism and communication at Michigan State University, about how the way we consume media affects our scientific knowledge and how we feel about scientists and the press.