Paediatric heart transplantation during the COVID‐19 pandemic in Iran: single‐centre experience

AIMS: Transplant services were imposed to the multiple challenges of insufficient facilities and resources during the COVID‐19 pandemic. Thus, each centre modified and altered its routine practice to maintain the service. We report our experience in Iran's single‐centre paediatric heart transplantation unit during the 2 year pandemic in transplant rate and early transplant outcomes. METHODS AND RESULTS: We retrospectively reviewed all paediatric heart transplants performed at our centre between 19 February 2020 and February 2022. We studied the number and percentage of paediatric transplanted patients who developed COVID‐19, in‐hospital outcome, 30 day survival and left ventricular function during the first month of the follow‐up visit. From February 2020 to February 2022, 59 transplants were performed compared with 62 patients from February 2018 to 2020. Compared with the year before the pandemic, the heart transplant rate was reduced by 34% in the first year of the pandemic; however, it bounced back in the second year with a 19% increase. The in‐hospital mortality rate during the 2 year pandemic was (11.8%). One death occurred related to COVID‐19 acute respiratory distress syndrome. The in‐hospital COVID‐19 infection rate was 11 patients (18%). In the 30 day follow‐up, the overall 30 day survival rate was 88%, and the 30 day rejection rate was 10%. The mean left ventricular ejection fraction was (53.6 ± 4.9), the mean left ventricular global longitudinal strain was −16.9 ± 3.3, and the mean right ventricular global longitudinal strain was −17.0 ± 3.8 with no significant difference between patients with in‐hospital COVID and other recipients (P = 0.1, P = 0.2 and P = 0.2). CONCLUSIONS: Throughout the pandemic, although we experienced a reduction in the transplant rate in the first year, with the increasing vaccination rate in health care and later in the general population, we continued to maintain our transplant rate by incorporating safety protocols and more resources.