{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:23:25Z","timestamp":1787840605174,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective and Aims:<\/jats:title>\n                    <jats:p>Pediatric heart transplantation (HTx) for children with single-ventricle (SV) physiology remains a complex and high-risk procedure. This study aimed to retrospectively evaluate long-term outcomes in patients with SV undergoing primary HTx versus HTx after failed staged palliation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between 1991 and 2025, 22 pediatric patients (aged \u2264 18 years) with SV physiology underwent orthotopic HTx. Thirteen received primary HTx (Group 1), and nine had HTx after failed staged palliation (Group 2), including two post-Norwood, three post-Glenn, and four post-Fontan procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The 10-year survival rate was 71.6%, with similar re-transplant-free survival. The median transplant age was 0.22 years (interquartile range [IQR], 0.08\u20130.49) for Group 1 and 15.1 years (IQR, 3.0\u201316.5) for Group 2. Posttransplant extracorporeal membrane oxygenation was needed in three patients in Group 1 and six patients in Group 2. Coronary vasculopathy (grades I\u2013III) occurred in eight patients in Group 1 and 5 patients in Group 2; one patient in each group underwent re-HTx. Cytomegalovirus positivity was found in three and one patients; Epstein\u2013Barr virus positivity in six and two patients (Groups 1 and 2, respectively). Rejection (grades 0\u2013II) occurred in 7 and 2 patients, respectively. Posttransplant lymphatic disorder developed in four patients (Group 1). Immunosuppression was changed in 10 patients (Group 1) and 6 patients (Group 2). Three patients in Group 1 required pacemakers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>HTx is feasible for pediatric SV patients. Primary Tx in infancy may involve shorter operative times, whereas HTx after failed palliation, especially post-Fontan, is more complex and associated with higher morbidity. Early referral and tailored treatment are essential. Multicenter prospective studies are needed to improve patient selection and address donor availability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/apc.apc_209_25","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T12:00:13Z","timestamp":1773662413000},"page":"541-550","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes of pediatric heart transplantation in single-ventricle heart disease: A single-center analysis"],"prefix":"10.4103","volume":"18","author":[{"given":"L. Lily","family":"Rosenthal","sequence":"first","affiliation":[{"name":"Division for Pediatric and Congenital Heart Surgery, LMU University Hospital Munich, Munich, Germany"},{"name":"European Pediatric Heart Center Munich, Munich, Germany"},{"name":"Department of Congenital and Pediatric Heart Surgery, Technical University of Munich, German Heart Center Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinrich","family":"Netz","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology and Intensive Care, LMU University Hospital, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus A.","family":"Haas","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology and Intensive Care, LMU University Hospital, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carola","family":"Grinninger","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, LMU University Hospital, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rgen","family":"H\u00f6rer","sequence":"additional","affiliation":[{"name":"Division for Pediatric and Congenital Heart Surgery, LMU University Hospital Munich, Munich, Germany"},{"name":"European Pediatric Heart Center Munich, Munich, Germany"},{"name":"Department of Congenital and Pediatric Heart Surgery, Technical University of Munich, German Heart Center Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Michel","sequence":"additional","affiliation":[{"name":"Division for Pediatric and Congenital Heart Surgery, LMU University Hospital Munich, Munich, Germany"},{"name":"European Pediatric Heart Center Munich, Munich, Germany"},{"name":"Department of Congenital and Pediatric Heart Surgery, Technical University of Munich, German Heart Center Munich, Germany"},{"name":"Department for Cardiovascular Diseases, 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