Chapter 7 **Mechanical Circulatory Support as Bridge to Pediatric Heart Transplantation 93**

Martin Schweiger and Michael Huebler


Loforte, Giuseppe Marinelli, Luciano Potena and Francesco Grigioni

Preface

terms of teamwork.

treatment of refractory end-stage heart failure.

Heart transplantation currently remains the 'gold standard' solution in terms of 'radical'

In December 2017 we celebrated the 50th anniversary of the world's first human heart trans‐ plant and over time the results have increasingly improved. Historically and currently, ini‐ tial limitations such as 'no proper' definement of brain death, timing for organ procurement with the need of heart electrical activity cessation, absence of 'correct' cold organ storage not allowing long-distance transportation, the need of an adequate immunosuppressive thera‐ py, the requirement of multidisciplinary teamwork, proper recipient and donor selection, and lack of donors to be balanced by reliable technology in terms of both temporary extrac‐ ardiac and long-term implantable mechanical circulatory support therapy are now outdated,

Thanks to the contributions of well-known experts in the field, the goal of this book is to provide a framework for a successful transplant program development and management. The text reflects the global collective efforts of those who have dedicated countless energy to achieving a better understanding of the details that will ultimately yield better outcomes in

The book is divided into different sections. The chapters focus on historical background and transplant evolution, the current transplant clinical panorama, indications and patient selec‐ tion, both adult and pediatric transplant population issues, intra- and perioperative settings,

This is an additional contribution to the field of heart transplantation, which hopefully will inspire others to further advance this 'milestone' in terms of adequate treatment of end-

> Department of Cardiothoracic, Transplantation and Vascular Surgery S. Orsola Hospital, ALMA Mater Studiorum University of Bologna, Italy

> > Department of Cardiac Surgery and Transplantation

Department of Cardiac Surgery and Transplantation

**Dr. Antonio Loforte, MD, PhD**

Cardiothoracic Surgeon

**Dr. Andrea Montalto, MD** Cardiothoracic Surgeon

S. Camillo Hospital, Rome, Italy **Dr. Cristiano Amarelli, MD** Cardiothoracic Surgeon

Monaldi Hospital, Naples, Italy

thus providing a dramatic expansion of heart transplantation therapy.

stage heart failure, which will dramatically affect most of our patients.

surgical strategies, and transplant-related adverse events.

	- **Section 5 Related Adverse Events 157**
