Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 33(1): 17-23 (2017)


アメリカでの小児重症心不全医療の現状Current Status of Treatment for Advanced Heart Failure of Children in the United States

東京大学医学部附属病院心臓外科Department of Cardiac Surgery, The University of Tokyo Hospital ◇ Tokyo, Japan

発行日:2017年1月1日Published: January 1, 2017


In the United States, approximately 400 pediatric heart transplants are performed each year. When a deceased organ donor is identified, the UNOS’ computer system generates a ranked list of transplant candidates based on blood type, medical urgency, waiting time, expected benefit, geography, and other medical criteria. The average waiting time is approximately 2–3 months. The survival rate after the transplant is improving and the 5-year survival rate after the transplant is approximately 80%. Dilated cardiomyopathy is the most common indication for the transplant, but approximately 40% of the cases are with congenital heart disease, and transplantation after Fontan failure has been increasing recently. The most common circumstance of brain death is a motor vehicle accident, but unlike Japan, child abuse is also included. After the approval of the Berlin heart EXCOR in 2011, the number of patients with VAD is increasing and the results are excellent. There are some promising pediatric implantable VADs in the market and in preclinical trials.

Key words: pediatric heart transplant; heart failure; pediatric ventricular assist device

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