Significant Advances in Pediatric Heart Transplant Survival in Nordic Countries

A comprehensive observational study conducted by researchers at Lund University in Sweden has revealed notable improvements in survival rates for children undergoing heart transplantation across the Nordic countries from 1986 to 2023. The study analyzed data from 597 children listed for a heart transplant, with 461 of them receiving transplants within the period. Despite the small population sizes and limited number of procedures annually, survival outcomes have improved markedly over the decades.

The research, published in the Journal of Heart and Lung Transplantation, highlights a decline in mortality among children on the waiting list from 22.8% in 1986–1998 to just 6.8% in 2012–2023. Additionally, long-term survival after transplant remains high, with 78% of children alive ten years post-operation, and more than half of those who could live up to 30 years with their new hearts are still living today.

A key factor behind these positive trends is the significant technological progress in transplantation care, including the use of circulatory support devices like ECMO and the Berlin Heart, which help sustain children during the waiting period. Moreover, earlier listing of children for transplants — before their condition becomes critical — coupled with better supportive therapies, has contributed to enhanced survival rates despite longer waiting times, which increased from a median of 38 to 63 days.

The study also emphasizes that organ sharing within Scandinavia plays a vital role, with approximately 40% of donor hearts for pediatric transplants in Sweden originating from Nordic donors. While outcomes in these small centers are comparable to larger international centers, challenges remain, particularly in improving long-term survival and managing complications associated with lifelong immunosuppression, such as rejection, infections, and cancers.

Research team members stress the importance of ongoing development in diagnostic techniques, medicines, and transplant protocols, especially for complex cases like single ventricle patients, who often face additional challenges and require careful timing for transplantation. The findings suggest that increased awareness and technological advancements will continue to improve the outlook for children requiring heart transplants in the Nordic region.

For further details, the full study can be accessed through the DOI link: 10.1016/j.healun.2025.05.020. Source: https://medicalxpress.com/news/2025-08-survival-pediatric-heart-transplantation-nordic.html