Abstract
For a long time, small children could not undergo either a heart transplantation (HTx) or heart-lung transplantation (HLTx) in Japan and many Japanese children were compelled to go abroad to undergo an HTx. After revision of the Organ Transplant Act, a small child could donate organs if the family allowed it, and in fact, eventually six children (one less than 6 years old, three from 10 to 14, and two 15 and 17) had donated his or her heart by the end of 2013. In this review, the current status of pediatric HTx and HLTx in Japan and an indication of pediatric HTx and HLTx and management before and after HTx were described. Briefly, most indications of HTx were dilated cardiomyopathy (DCM) and restrictive cardiomyopathy in Japan and many candidates with DCM required a left-ventricular assist device (LVAS) for a bridge to HTx in Japan. Patient survival at 10 years after HTx was 100% in children transplanted in Japan and 87.6% in children transplanted abroad. No child has undergone an HLTx yet. Post transplant lymphoproliferative disorder and various infections were major morbidity and mortality. Non-adherence should be paid attention, especially during the care of adolescent patients.
