• Joseph W Rossano, Antonio G Cabrera, and Robert E Shaddy.
• 1Department of Pediatrics, Section of Cardiology, The Perelman School of Medicine at the University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, PA. 2Department of Pediatrics, Section of Cardiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX.
• Pediatr Crit Care Me. 2016 Aug 1; 17 (8 Suppl 1): S171-7.

ObjectivesAlthough there have been tremendous advancements in the care of severe pediatric cardiovascular disease, heart transplantation remains the standard therapy for end-stage heart disease in children. As such, these patients comprise an important and often complex subset of patients in the ICU. The purpose of this article is to review the causes and management of allograft dysfunction and the medications used in the transplant population.Data SourcesMEDLINE, PubMed, and Cochrane Database of systemic reviews.ConclusionsPediatric heart transplant recipients represent a complex group of patients that frequently require critical care. Their immunosuppressive medications, while being vital to maintenance of allograft function, are associated with significant short- and long-term complications. Graft dysfunction can occur from a variety of etiologies at different times following transplantation and remains a major limitation to long-term posttransplant survival.

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