Study of Organ Perfusion in Heart Transplantation in Children

Orthotopic Heart transplantation (or cardiac transplantation) is a procedure performed in patients with end stage heart failure when other treatments have failed.

The surgical procedures for orthotopic heart transplantation are essentially the same in adult and paediatric patients . Due to anatomical variants in congenital heart disease the procurement procedure may be modified with regard to the extent of the Vena cava superior and the great vessels. In implantation most frequently the bicaval technique is used but the biatrial technique which is leaving the back wall of both atria in situ may also be employed.

A main difference between adult and paediatric heart transplantation (HTx) are the indications for transplantation: In adults the majority of patients undergo HTx as treatment of end stage heart failure due to cardiomyopathy or severe coronary artery disease when other treatments have failed. Infants younger than one year of age congenital heart disease (CHD) is the most common diagnosis representing more than every second case followed by dilated cardiomyopathy (DCM) in more than one third of cases. In older patients DCM is the most frequent underlying diagnosis. CHD may include patients who have undergone corrective surgery and in whom myocardial dysfunction develops later .

• heart rate [Срок оценки: up to day 7 after release of the aortic cross clamp]
• blood pressure (systolic (SBP) and diastolic (DBP)) [Срок оценки: up to day 7 after release of the aortic cross clamp]
• body temperature [Срок оценки: up to day 7 after release of the aortic cross clamp]
• concentration of cardiac troponin [Срок оценки: up to day 7 after release of the aortic cross clamp]
• concentration of creatinine kinase (CK-MB) [Срок оценки: up to day 7 after release of the aortic cross clamp]
• (SBP (systolic blood pressure), DBP (diastolic blood pressure)) [Срок оценки: from termination of cardiopulmonary bypass until transfer to intensive care unit]
• Heart Rhythm (HR) [Срок оценки: from termination of cardiopulmonary bypass until transfer to intensive care unit]
• Pulmonary artery pressure (PAP (if available)) [Срок оценки: from termination of cardiopulmonary bypass until transfer to intensive care unit]
• Cerebrovascular resistance (CVP (if available)) [Срок оценки: from termination of cardiopulmonary bypass until transfer to intensive care unit]
• Death [Срок оценки: up to 12 months]
• function of transplanted organ (heart) [Срок оценки: up to 12 months]
• Readmission to intensive care unit (ICU) [Срок оценки: up to 12 months]