Indication for Pediatric Heart Transplantation – Romanian Peculiarities

Background: Heart transplantation is nowadays a well established and succesfull therapy in both pediatric and adult heart failure. There are several guidelines for adult transplantation, while pediatric transplantation benefits of the indications established in 2007 by the American Heart Association. These are based on western experience and infrastructure. In Romania, this therapy is being performed mainly in the last 5 years, with a small number of patients transplanted.
Methods: We have analyzed the way indication for transplantation has been established in our 5 patients and compared it to the recommendations from the generally accepted guidelines.
Results: There are significant differences regarding age at transplantation, underlying heart disease, as well as stage of heart failure and medical therapy before transplantation. Our patients are older, transplanted mainly for dilated cardiomyopathy, mainly in NYHA functional class IV, but not hospitalized or on intensive care.
Conclusion: There is an imperative need for establishing the number of necessary donor hearts at a national level, as well as starting a vigurouse campaign to increase organ donation in Romania.