Pediatric Heart Transplantation after Declaration of Cardiocirculatory Death

This report describes transplantation of hearts from three infant donors (mean age at donation, 3.7 days) who had died from cardiocirculatory causes. The recipients (mean age, 2.2 months) all survived to 6 months with excellent left ventricular function. This approach to transplantation has been controversial but offers the prospect of expanding the donor pool. This report describes transplantation of hearts from three infant donors who had died from cardiocirculatory causes. The recipients all survived to 6 months with excellent left ventricular function. This controversial approach offers the prospect of expanding the donor pool. Pediatric heart transplantation after the declaration of brain death in donors has been performed for more than 25 years in more than 6000 recipients. 1 The first successful heart-transplant procedure in an infant was reported 20 years ago, and decades-long survival has been reported. 1 , 2 The average survival for children who are alive 1 year after transplantation is more than 15 years and exceeds that of adults. 3 However, the risk of death while awaiting a donor is highest for children awaiting a cardiac transplant. 4 Infant heart-transplant recipients face up to a 25% waiting-list mortality, which is an order of magnitude higher . . .