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Heart transplantation is considered an established therapeutic option for patients with end-stage heart disease. The long-term outcomes of pediatric heart transplantations were comparable to those of adults. Issues affecting long-term outcomes include acute cellular rejection, antibody-mediated rejection, cardiac allograft vasculopathy, infection, prolonged renal dysfunction, and malignancies such as posttransplant lymphoproliferative disorder. This article focuses on medical issues before pediatric heart transplantation, according to the Korean Network of Organ Sharing registry and as well as major problems such as graft rejection and cardiac allograft vasculopathy. To reduce graft failure rate and improve long-term outcomes, meticulous monitoring for rejection and medication compliance are also important, especially in adolescents.<\/jats:p>","DOI":"10.3345\/cep.2019.01417","type":"journal-article","created":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T06:30:28Z","timestamp":1606285828000},"page":"49-59","update-policy":"https:\/\/doi.org\/10.3345\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Pediatric heart transplantation: how to manage problems affecting long-term outcomes?"],"prefix":"10.3345","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7960-4752","authenticated-orcid":true,"given":"Young Hwue","family":"Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1897","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(68)90173-2"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2012.08.003"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.08.018"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.08.003"},{"key":"ref5","first-page":"328","volume-title":"","author":"Boyle","year":"2000"},{"key":"ref6","first-page":"342","volume-title":"","author":"Webber","year":"2000"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2011.04.042"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2011.06.005"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.09.027"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.07.011"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2009.08.008"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s11936-011-0143-8"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.05.034"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12309"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2009.02.012"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.01.1310"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1097\/01.hco.0000210309.71984.30"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(93)90138-Y"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.4016\/36035.01"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12153"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-016-1533-1"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.05.017"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.07.048"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2012.02.003"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2012.09.030"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951115000918"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2009.01074.x"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13542"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2005.01175.x"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03550220199025"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.05.026"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15339"},{"key":"ref33","first-page":"813","volume-title":"Heart transplant rejection with hemodynamic compromise: a multiintstitutional study of the role of endomyocardial cellular infiltrate. 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