Heart transplantation (HT) in children is a method of treating severe heart diseases when all other treatment options are exhausted. Although HT in adults is now considered a routine operation, in children it is a much more complex and demanding procedure. (1) In the complex process of preparing a child for transplantation and postoperative care, the flawless cooperation of team members is crucial. Heart transplantation aims to prolong the life of a child, enable normal growth and return to an active life. Heart transplantation is intended primarily for children with cardiomyopathies, less frequently with severe arrhythmias or congenital heart defects. In order to perform a HT, it is first of all necessary to achieve the theoretical and practical conditions prescribed by the Eurotransplant system: selection criteria, examination protocol during processing for HT and readiness of the cardiac surgery team. After the criteria are met, it is necessary to plan adequate postoperative care and health care for the child.
The paper will present the HT program in children at the University Hospital Centre Zagreb. Heart transplantation has been performed since 2011. According to the Register of the International Society for HT, 300 to 400 HT in children are made worldwide every year, or 10% of all HT. Longer survival has been achieved with complex guidelines for screening donors and organ recipients, remarkable advances in immunosuppressive therapy, performing endomyocardial biopsies, and thus patient care in the period before and after transplantation. Raising awareness about HT in children is very important for raising awareness about organ donation as it is the biggest limiting factor of this method. The stay of the child after the transplant at Clinic is aimed at bringing the child closer to the parents, monitoring the rejection of the transplant, monitoring postoperative infections and parents’ education led by the physician and nurse.
The success of a HT in a child depends on the timely diagnosis and recognition of the terminal stage of the disease, the ability of the cardiac surgery team and the ability to adequately care for the child after a HT. Treatment requires multidisciplinary cooperation and support from parents and the environment in which the child lives.