Early outcomes of cardiac transplantation in adult patients with congenital heart disease and potential strategies for improvement

With significant improvements in the medical and surgical management of patients with congenital heart disease, prognosis has improved substantially in the last several decades. However, many lesions are still associated with the eventual development of progressive heart failure, resulting in an increasing number of adults with congenital heart disease potentially requiring heart transplant. This presents many challenges, ranging from difficulty in determining the appropriate timing of transplant and organ allocation, to technical challenges in the operating room and problems with postoperative anti-rejection medication management. While recent studies have attempted to clarify many of these issues, questions remain.