Adult and Pediatric Perspectives on Heart Retransplant

At the Ethics of the Heart II: Ethical and Policy Challenges in Congenital Heart Disease Conference, March 16-17, 2012 in Philadelphia, Pennsylvania, one of the sessions focused on the issues related to end-stage heart failure in patients with congenital heart disease including utilizing the therapy of heart transplantation. This article will summarize the session related to repeat heart transplant that was based on discussion of actual patient cases, two adults and one pediatric, presented, respectively, by an adult and a pediatric heart transplant specialist. Outcome data related to retransplant for both adult and pediatric heart transplant populations are reviewed. The complicated ethical issues related to considerations of beneficence versus nonmalfeasance by a medical care team for an individual patient, patient autonomy related to adherence, and obligations to society to fairly allocate the scarce precious resource of donor organs are discussed.

[1]  E. Pahl,et al.  Current therapies for cardiac allograft vasculopathy in children. , 2012, Congenital heart disease.

[2]  A. Rahmel,et al.  The Registry of the International Society for Heart and Lung Transplantation: Fourteenth Pediatric Heart Transplantation Report--2011. , 2011, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[3]  N. Uriel,et al.  Higher rate of comorbidities after cardiac retransplantation contributes to decreased survival. , 2009, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[4]  A. Haverich,et al.  Cardiac retransplantation: is it justified in times of critical donor organ shortage? Long-term single-center experience. , 2008, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[5]  J. Shuhaiber,et al.  Comparison of survival in primary and repeat heart transplantation from 1987 through 2004 in the United States. , 2007, The Annals of thoracic surgery.

[6]  W. Mahle,et al.  Cardiac retransplantation in childhood: analysis of data from the United Network for Organ Sharing. , 2005, The Journal of thoracic and cardiovascular surgery.