Kids who undergo heart transplant living longer, study says

by Mary Brophy Marcus, Healthday Reporter
Kids who undergo heart transplant living longer: study
Many are surviving 15 years and beyond, researchers find.

(HealthDay)—More than half of babies and children who receive heart transplants are surviving many years, say the authors of a new study.

Pediatric are living 15 years and longer with good heart function, the scientists said. They are scheduled to present their findings Tuesday at the annual meeting of the Society of Thoracic Surgeons, held in Orlando, Fla.

Study author Dr. Hannah Copeland, a thoracic surgery fellow at Loma Linda University Medical Center in California, and colleagues analyzed data from 337 young patients who received between the ages of birth and 17 years.

All of the children underwent surgery at Loma Linda Children's Hospital between 1985 and 1998. The researchers reported that 54 percent (183 of 337 patients) survived at least 15 years.

The news gives hope, Copeland said. "Children are surviving transplant surgeries. More than half of the patients in our study survived," she noted. "We're saying if your child needs a heart transplant, they can live for a long period of time."

The average adult survival rate after a heart transplant is 10 years, Copeland said. "We looked at 15 years in children because there are few studies on that many years out. We also wanted to look at quality of life factors, as well," she said.

Of the 15-year survivors, 82.5 percent were alive and showed good heart function at their most recent follow-up appointment, Copeland added.

A condition called "cardiac allograft vasculopathy" is the biggest hurdle to long-term survival after a transplant, the researchers noted.

"Graft vasculopathy is a thickening of the blood vessels which makes the vessels themselves smaller and therefore it's harder to get oxygen and 'food' to the heart," said Elizabeth Blume, medical director of the pediatric heart transplant program at Boston Children's Hospital. Blume was not involved with the study.

Kidney failure is also a complication. The medications children take to suppress their immune systems to prevent their bodies from rejecting the new heart can be damaging to the kidneys. But study author Copeland said kidney transplants, as well as second and third heart transplants, and newer medications are also helping to extend lives.

It's an "important" abstract, said Blume, who is also an associate professor of pediatrics at Harvard Medical School.

"It does provide us with a lot of the data that we need," Blume said. "This is a large population of patients who are surviving far out, which I think provides important data for the field. On the other hand, there's a lot of re-transplanting needed, and a lot of kidney dysfunction, and it does challenge us to do better and to find ways to address the long-term issues."

Copeland noted that "many challenges still exist for long-term survival in kids—this isn't a cure."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information: Visit the heart transplant program at Boston Children's Hospital to learn more about heart transplantation in kids.

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