Heart and heart–lung transplant

Heart transplantation not only enables children with end-stage heart failure to live longer, but also improves their quality of life. Peritransplant survival has improved with advances in intensive care and better mechanical support systems for the failing heart. Heart–lung transplantation is the only option for some children near the end of life from disease affecting both organs and remains a challenge, with much poorer outcomes than heart transplantation alone. All thoracic transplants require scrupulous attention to follow-up care and, despite improving outcomes, can be regarded only as palliative solutions. The medical and surgical management of heart failure and congenital heart disease has also improved in recent years, and these options are thoroughly explored before considering listing for heart transplantation.