Transplant vs. corrective surgery

In some cases when the heart suffers pathologies that can’t be fixed, a transplant is the only hope. In children, this extreme measure is only indicated for those cases in which an irreversible illness affects the main piece and engine of the circulatory system.

Most of these cases derive from acquired diseases. The most frequent are viral and other types of illnesses that injure the cardiac muscle, without possibility of recovery. However, there are a few cases in which a transplant is indicated for congenital illness.

Congenital cardiopathies now have the possibility of corrective or palliative surgery. These small patients, who have been born with malformed hearts, receive a very good surgical therapy which allows their proper growth and development. Only if they reach the age of 8 or 9 with an irreversible malfunction, will they be candidates for transplants.

Cardiac transplantation requires well trained cardiovascular surgeons. It is also necessary to have a well developed organization, which includes detecting the possible donor, observing the legal aspects, and the optimum conditions for transporting the organ in the correct time and form. This is very important, since while in one operating room the donor’s heart is being taken out, the receiving patient is being prepared.

The speed and coordination of this action is crucial, since the success of every transplant relies on the operation’s organization. An extracted heart can only be preserved without irrigation for up to four hours maximum.

For being compatible, the donor should be of the same blood type and factor as the receiver, plus other histocompatibility factors. Age, weight and height must also be taken into consideration. Generally the pediatric heart transplant accepts hearts of higher ages and sizes, since receiving children have a dilated heart, which has enlarged the thoracic cavity. Once transplanted, the heart’s muscle continues to develop and adapts to the receiving body’s growth.

Collaborated in this article: Dr. Horacio Vogelfang

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