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Current availability and status of paediatric cardiac transplantation and mechanical circulatory support in twenty-eight European countries

van der Have, Oscar LU orcid ; Dunne, Esme ; Tran-Lundmark, Karin LU ; Wacker, Julie ; Michel-Behnke, Ina ; Koubsky, Karel ; Krauss, Annemarie ; Van Cleemput, Johan ; Stephensen, Sigurdur Sverrir LU and Dalinghaus, Michiel , et al. (2026) In European Journal of Pediatrics 185(5). p.1-13
Abstract

UNLABELLED: We sought to investigate the inter- and intra-country variation in paediatric heart transplantation (HTx) and mechanical circulatory support (MCS) availability and practice in Europe. Data was obtained through a survey circulated to paediatric transplant cardiologists identified through the Association of European Paediatric and Congenital Cardiology between November 2022 and March 2023. Twenty-eight respondents from twenty-eight European countries completed the survey. Twenty-four (86%) had paediatric and 25 (89%) had adult congenital HTx services. National paediatric HTx centre density ranged from 0.00 to 5.35 per 10 million inhabitants. Eighteen (64%) countries followed either Eurotransplant or Scandiatransplant protocols... (More)

UNLABELLED: We sought to investigate the inter- and intra-country variation in paediatric heart transplantation (HTx) and mechanical circulatory support (MCS) availability and practice in Europe. Data was obtained through a survey circulated to paediatric transplant cardiologists identified through the Association of European Paediatric and Congenital Cardiology between November 2022 and March 2023. Twenty-eight respondents from twenty-eight European countries completed the survey. Twenty-four (86%) had paediatric and 25 (89%) had adult congenital HTx services. National paediatric HTx centre density ranged from 0.00 to 5.35 per 10 million inhabitants. Eighteen (64%) countries followed either Eurotransplant or Scandiatransplant protocols for organ allocation and 59% of the surveyed countries had low HTx volumes (< 4 paediatric HTx annually), based on the self-reported numbers. A ventricular assist device (VAD) programme was operational in 22 (79%) countries. In only 9 countries (38%), there were dedicated resources for HTx as part of the hospital budget; however, a vast majority (77%) reported that families suffered no cost when a VAD was utilised. Twenty-one countries (78%) reported limited intensive care unit beds and 14 (54%) reported that HTx impacted on congenital heart surgery cases. Only 12 of 27 countries (44%) had a standardised national protocol for post-HTx care. There was no correlation between paediatric HTx centre density, population or GDP per capita.

CONCLUSION: There is a high degree of variation both within and between the surveyed European countries with regard to paediatric HTx centre density, VAD availability, listing protocols, and post-HTx management. Multiple factors contribute to this heterogeneity, which makes standardisation of HTx listing and VAD criteria challenging. Increased cross-national collaborative efforts between European countries may strengthen both HTx and MCS availability and outcomes, especially in regions with several smaller neighbouring countries.

WHAT IS KNOWN: • The care of paediatric heart transplant (HTx) and mechanical support (MCS) patients varies across Europe.

WHAT IS NEW: • This paper elucidates the differences in transplant service organisation and the care of transplant and MCS patients in twenty-eight European countries. • These findings could potentially encourage broader open dialogue and facilitate collaboration across European paediatric HTx centres with development of standardised listing criteria, improved collective European registry data and creation of standards for screening post-HTx patients.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Heart Transplantation/statistics & numerical data, Humans, Europe, Heart-Assist Devices/statistics & numerical data, Child, Heart Defects, Congenital/surgery, Health Services Accessibility/statistics & numerical data, Surveys and Questionnaires
in
European Journal of Pediatrics
volume
185
issue
5
article number
267
pages
1 - 13
publisher
Springer
external identifiers
  • pmid:41984231
  • scopus:105035821263
ISSN
1432-1076
DOI
10.1007/s00431-026-06927-1
language
English
LU publication?
yes
additional info
© 2026. The Author(s).
id
346d3499-edcb-456f-8e2a-85323bfac7ec
date added to LUP
2026-04-22 16:01:17
date last changed
2026-07-03 00:27:20
@article{346d3499-edcb-456f-8e2a-85323bfac7ec,
  abstract     = {{<p>UNLABELLED: We sought to investigate the inter- and intra-country variation in paediatric heart transplantation (HTx) and mechanical circulatory support (MCS) availability and practice in Europe. Data was obtained through a survey circulated to paediatric transplant cardiologists identified through the Association of European Paediatric and Congenital Cardiology between November 2022 and March 2023. Twenty-eight respondents from twenty-eight European countries completed the survey. Twenty-four (86%) had paediatric and 25 (89%) had adult congenital HTx services. National paediatric HTx centre density ranged from 0.00 to 5.35 per 10 million inhabitants. Eighteen (64%) countries followed either Eurotransplant or Scandiatransplant protocols for organ allocation and 59% of the surveyed countries had low HTx volumes (&lt; 4 paediatric HTx annually), based on the self-reported numbers. A ventricular assist device (VAD) programme was operational in 22 (79%) countries. In only 9 countries (38%), there were dedicated resources for HTx as part of the hospital budget; however, a vast majority (77%) reported that families suffered no cost when a VAD was utilised. Twenty-one countries (78%) reported limited intensive care unit beds and 14 (54%) reported that HTx impacted on congenital heart surgery cases. Only 12 of 27 countries (44%) had a standardised national protocol for post-HTx care. There was no correlation between paediatric HTx centre density, population or GDP per capita.</p><p>CONCLUSION: There is a high degree of variation both within and between the surveyed European countries with regard to paediatric HTx centre density, VAD availability, listing protocols, and post-HTx management. Multiple factors contribute to this heterogeneity, which makes standardisation of HTx listing and VAD criteria challenging. Increased cross-national collaborative efforts between European countries may strengthen both HTx and MCS availability and outcomes, especially in regions with several smaller neighbouring countries.</p><p>WHAT IS KNOWN: • The care of paediatric heart transplant (HTx) and mechanical support (MCS) patients varies across Europe.</p><p>WHAT IS NEW: • This paper elucidates the differences in transplant service organisation and the care of transplant and MCS patients in twenty-eight European countries. • These findings could potentially encourage broader open dialogue and facilitate collaboration across European paediatric HTx centres with development of standardised listing criteria, improved collective European registry data and creation of standards for screening post-HTx patients.</p>}},
  author       = {{van der Have, Oscar and Dunne, Esme and Tran-Lundmark, Karin and Wacker, Julie and Michel-Behnke, Ina and Koubsky, Karel and Krauss, Annemarie and Van Cleemput, Johan and Stephensen, Sigurdur Sverrir and Dalinghaus, Michiel and Šijak, Dorotea and Topalovic, Mirko and Lubaua, Inguna and Ulger, Zulal and Vida, Vladimiro and Juul, Klaus and Balmer, Christian and Mesihovic-Dinarevic, Senka and Fragata, José and Maruszewski, Bohdan and Sarkola, Taisto and Ablonczy, László and Muntean, Iolanda and Zahorec, Martin and Chaudhari, Milind and Möller, Thomas and Bonnet, Damien and Simmonds, Jacob and Reinhardt, Zdenka and McMahon, Colin J}},
  issn         = {{1432-1076}},
  keywords     = {{Heart Transplantation/statistics & numerical data; Humans; Europe; Heart-Assist Devices/statistics & numerical data; Child; Heart Defects, Congenital/surgery; Health Services Accessibility/statistics & numerical data; Surveys and Questionnaires}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{5}},
  pages        = {{1--13}},
  publisher    = {{Springer}},
  series       = {{European Journal of Pediatrics}},
  title        = {{Current availability and status of paediatric cardiac transplantation and mechanical circulatory support in twenty-eight European countries}},
  url          = {{http://dx.doi.org/10.1007/s00431-026-06927-1}},
  doi          = {{10.1007/s00431-026-06927-1}},
  volume       = {{185}},
  year         = {{2026}},
}