Background: More patients with congenital heart disease (CHD) are surviving into adulthood and require heart transplantation. These patients historically experienced worse survival early after transplantation. The purpose of this study was to review outcomes in a center with a multidisciplinary approach to cardiac transplantation of patients with CHD.

Methods: CHD patients at our center are evaluated by a multi-disciplinary team of adult and CHD trained cardiologists and surgeons. A retrospective review of all transplants between 9/2011 and 8/2017 was performed. Outcomes of patients with CHD were compared to all other diagnoses. Kaplan-Meier plots were generated and survival was compared by the log rank test. Other characteristics were analyzed using the Kruskal-Wallis and Fisher's exact tests. A p-value < .05 was considered significant.

Results: 14 patients with CHD out of 195 total transplants performed were identified. CHD patients underwent 2.23 (range 1-4) prior cardiac operations. There were 3 single ventricle physiology cases all treated with heart transplantation alone. 57% of CHD patients required additional reconstructive procedures at the time of transplant. Cardiopulmonary bypass and aortic cross clamp times were longer in patients with CHD consistent with the increased surgical complexity. Warm and total ischemic times were also prolonged in CHD patients but this difference did not reach statistical significance. Survival was not different between groups.

Conclusions: Cardiac transplantation in adult patients with CHD can be technically challenging often requiring additional reconstructive procedures. However, with a specialized team, excellent outcomes are achievable.

CITATION INFORMATION: Zeng X., Vela R., Pruszynski J., Martinez J., Ring S., Peltz M. Outcomes after Cardiac Transplantation for Adult Congenital Heart Disease in the Modern Era Am J Transplant. 2017;17 (suppl 3).

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