Over the last 20 years, heart transplantation has become an established surgical option in children with once inoperable heart disease.  A new medication, cyclosporine, introduced during the 1980s, markedly improved survival after organ transplantation and encouraged many hospitals to consider heart transplantation for these children.  During the last decade, approximately 350 children have undergone heart transplantation worldwide each year. 

Vanderbilt University Medical Center performed its first pediatric heart transplantation in 1987 and established a Pediatric Heart Transplant Program in 1989.  This program works closely with The Transplant Center at Vanderbilt University which manages care for all adult and pediatric transplant recipients at Vanderbilt regardless of age or organ received.  The program also works closely with others physicians from the Division of Pediatric Cardiology.  Our pediatric cardiologists provide crucial interventional catheterization and arrhythmia management support for the children both before and after transplantation. 

Since initiation of the Pediatric Heart Transplant Program, we have performed 155 pediatric heart transplants and follow approximately 80 pediatric heart transplant patients at any given time.  In 2009 we performed 15 pediatric heart transplants. 

We have a particular interest in two groups with difficult issues regarding transplantation, the older child with complex congenital heart disease and the infant.  These groups are characterized by complex surgical issues in the older child with congenital heart disease, and complex management and surveillance issues in the infants.  At the time the program was initiated, we performed heart transplant as the primary procedure for those newborns with hypoplastic left heart syndrome, but now offer the Norwood procedure as the first palliation for this group of infants.  The program relies heavily on noninvasive monitoring (primarily echocardiography) for rejection and a maintenance immunosuppressive regimen that is steroid free. 

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