Pediatric heart, heart-lung, and lung transplantation: Preoperative management

Before heart transplantation, comprehensive care is focused on aggressive treatment of heart failure with oral drugs. Intensive intravenous therapy is necessary in some children, and mechanical support of ventilation is required in extreme cases. Prophylactic anticoagulation is recommended in patients with severe ventricular dysfunction. In all patients, general well being and nutrition must be reevaluated frequently, and comprehensive family education and psychosocial support is essential.