What are the different types of paediatric heart transplant?

A heart transplant is an effective treatment for an end-stage heart failure, including those with congenital defects, and with heart muscle disorders, when there is no known cure for a heart condition.

It is of course a very serious procedure with many risks, but it can give an extension of life and improved health for a child suffering with a serious heart condition such as restrictive cardiomyopathy. Here we take a look at the different kinds of heart transplant, and the highly talented specialists who perform these procedures.

Who performs a paediatric heart transplant?

A heart transplant would be performed by a paediatric cardiothoracic surgeon, a highly skilled surgeon who performs surgery within the chest cavity on paediatric patients, such as chest wall repair, heart surgery, lung surgery and tracheal surgery. Cardiothroracic surgery is a very challenging specialty, but rewarding when successful surgeries give children a prolonged life.

What are the different types of heart transplant?

If a child needs a heart transplant, there are a number of different types of procedure that your surgeon will choose the most appropriate in each case.

Orthotopic heart transplant

This is the standard procedure, and the most common performed. Orthotopic (meaning ‘in the right place’) heart surgery will involve the existing heart being removed, while a machine takes over, and a donor heart being implanted. A donor heart from a patient with the same blood type will be used where possible.

Heterotopic heart transplant

In this procedure, the child’s heart is not removed, but a donor heart is attached to the existing heart. The donor heart’s chambers and blood vessels are positioned so both hearts can be adjoined. The donor heart works as a kind of backup to the existing heart. This type of procedure is rare, and is carried out in a similar way to orthotopic transplant.

ABO mismatch transplant

In this type of heart transplant, a donor heart from a patient without the same blood type can be used. Research has found that in very young children, a mismatched organ may be accepted, as the child’s immune system has not yet fully developed meaning that the organ may not be rejected. This type of procedure can be used if a suitable donor heart isn’t available, and the waiting list is long.

After the heart transplant

Children receiving heart transplants often survive longer, including some for 15 or 20 years following surgery. This is a massive advancement from the early years of heart transplant. Progression of surgical techniques, improvements in immunosuppressive therapy, and advancements in knowledge further increase the survival rate and longevity of transplants.