Adults with congenital heart disease and heart transplantation: Optimizing outcomes

• Published in: The Journal of heart and lung transplantation Vol. 33; no. 9; pp. 873 - 877
• Main Authors: Goldberg, Sara W., MD, Fisher, Stacy A., MD, Wehman, Brody, MD, Mehra, Mandeep R., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2014
• Subjects: Adult; adults; congenital heart disease; Heart Defects, Congenital - mortality; Heart Defects, Congenital - surgery; Heart Transplantation; Humans; Middle Aged; morbidity and mortality; Outcome Assessment (Health Care); outcomes; Patient Selection; Surgery; Survival Rate; Treatment Outcome; Waiting Lists; congenital heart disease; morbidity and mortality; heart transplantation; outcomes; adults
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2014.05.001

The growing population of adults with congenital heart disease (ACHD) present a distinct set of challenges in the evaluation, listing, and safe performance of heart transplantation. We review existing literature to (1) describe the complex anatomic and physiologic features that characterize this group of patients, (2) discuss factors contributing to high waiting list times and waiting list morbidity and mortality experienced by this population, and finally, (3) identify risk factors for the elevated post-transplant morbidity and mortality reported in ACHD patients. We conclude with a discussion of critical areas in need of further investigation as well as ways to amend the current listing criteria to better accommodate ACHD patients in need of heart transplantation.