Heart transplantation represents the only effective method of treatment of intractable heart diseases. Cardiomyopathy
with heart dilation, inoperable congenital heart diseases and heart failure after the heart surgery represent the most
common indications for heart transplantation in pediatrics. Hypoplastic left heart syndrome is the most frequent
indication for the heart transplantation in neonates and infants. In infants steroids-free immunosuppression is used
or steroids are withdrawn 6 to 12 months after the transplantation. Graft failure, acute rejection and infection are
the most common causes of death after transplantation. Long-term results and the quality of life depend on the
occurrence of rejection, infection, graft vasculopathy, lymphoproliferative disease and side effects of immunosuppression.
Posttransplant graft vasculopathy, however, represents the most dangerous late complication, which requires
retransplantation. Improvement of the transplantation program improves the survival rate as well as the quality of
life after transplantation. Survival after heart transplantation is 80 % in one year and 50 % in ten years interval.
Better results can be achieved in neonates. Lack of donors, demanding economical and organisational conditions
and the unresolved legislation problems preclude wider use of heart transplantation in children. Research for more
effective, safer and cheaper pharmacotherapy in the prevention and treatment of rejection, infection and complications
of immunosupression is required. Long-term effects and the quality of life after heart transplantation in children, as
well as possibilities of mechanical heart support and xenotransplantation must be also studied.
Heart transplantation, heart failure, congenital heart diseases, cardiomyopathy, immunosuppression,