Causes of Cardiac Failure and Timing of Transplantation

  • Seth A. Hollander
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)


The term “heart failure” refers to a clinical syndrome in which the circulation fails to meet the metabolic needs of the body and remains the most common indication for heart transplantation in children. The etiology of heart failure in children can broadly be separated into two categories: (1) heart muscle diseases (cardiomyopathies), which may be further subcategorized as dilated, hypertrophic, or restrictive, depending on the dominant pathophysiology, or (2) as a result of failed palliation of congenital heart defects. Heart failure secondary to congenital heart disease is a growing indication for heart transplantation and may occur as left, right, or single ventricular failure. A significantly smaller, but important, minority of pediatric transplants occur for other indications, including protein-losing enteropathy and retransplantation.

Appropriate timing of heart transplant listing requires a thorough understanding of the mortality risk associated with heart failure and other diseases amenable to transplant. When considering a patient for transplant listing, several factors must be considered, including those that affect patient prognosis, transplant eligibility, and estimated time to organ allocation. This chapter outlines the most common reasons for transplantation in children, including the myriad causes of pediatric heart failure, highlighting the current indications for transplantation and the most important factors affecting both transplant candidacy and waitlist mortality.


Heart Failure Transplantation Cardiomyopathy Congenital heart disease Retransplantation Mechanical support Waitlist 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Stanford University Medical CenterLucile Packard Children’s Hospital StanfordPalo AltoUSA

Section editors and affiliations

  • Ryan R. Davies
    • 1
  1. 1.University of Texas Southwestern Medical CenterDallasUSA

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