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Journal of Transplantation
Volume 2013 (2013), Article ID 376027, 12 pages
http://dx.doi.org/10.1155/2013/376027
Review Article

Heart Transplantation in Congenital Heart Disease: In Whom to Consider and When?

1Division of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland
2Division of Cardiology, Department of Paediatric Cardiology and Congenital Heart Disease, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
3Department of Pathology, University Hospital Zurich, Zurich, Switzerland
4Congenital Heart Disease, Division of Cardiology, University Hospital Zurich, Raemistrße 100, 8091 Zurich, Switzerland

Received 29 July 2012; Accepted 19 December 2012

Academic Editor: Eric Thervet

Copyright © 2013 Christine H. Attenhofer Jost et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Due to impressive improvements in surgical repair options, even patients with complex congenital heart disease (CHD) may survive into adulthood and have a high risk of end-stage heart failure. Thus, the number of patients with CHD needing heart transplantation (HTx) has been increasing in the last decades. This paper summarizes the changing etiology of causes of death in heart failure in CHD. The main reasons, contraindications, and risks of heart transplantation in CHD are discussed and underlined with three case vignettes. Compared to HTx in acquired heart disease, HTx in CHD has an increased risk of perioperative death and rejection. However, outcome of HTx for complex CHD has improved over the past 20 years. Additionally, mechanical support options might decrease the waiting list mortality in the future. The number of patients needing heart-lung transplantation (especially for Eisenmenger’s syndrome) has decreased in the last years. Lung transplantation with intracardiac repair of a cardiac defect is another possibility especially for patients with interatrial shunts. Overall, HTx will remain an important treatment option for CHD in the near future.