There are 48 children and young people aged 0 to 17 in Italy awaiting a heart transplant as part of the National Pediatric Programme. The latest data says so National transplant centerupdated to December 31, 2024. Behind these numbers there are stories of families suspended between anxiety and hope, like that of the p2-year-old boy admitted to the Monaldi hospital in Napleswaiting for a new heart after the first transplant, carried out last December 23, was unsuccessful due to poor preservation of the organ during the transfer from Bolzano to Naples.
Cardiac transplantation in pediatric age is a very delicate operationmade even more complex by the rarity of compatible organs for such young children. The National Pediatric Transplant Program has been active in Italy since 1996, which provides a single national waiting list for all types of pediatric transplants. Hearts from donors under the age of 18 are given priority to pediatric patients.
The assignment of the organ takes into account rigorous criteria: compatibility of the ABO blood group, heart size, clinical severity of the recipient, location of the sampling and seniority on the list. In emergency cases, such as that of the child hospitalized in Naples, the first pediatric heart available in Italy is allocated to the little patient in more critical conditions.
Heart transplants in children are highly specialized life-saving procedures. The results are encouraging: survival one year after surgery is between 83% and 90%. Despite the scarcity of pediatric hearts — which makes donation an even more precious gesture — in some cases it is possible to use segments of adult organs. Modern techniques now allow a good quality of life, with five-year survival rates of between 88% and 90%.
However, possible complications remain, including transplant failure, when the new heart fails to function properly immediately after implantation. The evaluation for inclusion on the list and for the intervention is always carried out on the basis of the child’s clinical conditions and compatibility with the donor.
In 2024, a total of 191 pediatric transplants were carried out in Italy: 79 liver, 76 kidney, 32 heart and 4 lung. Numbers that tell of a network of healthcare excellence, but also the urgency of a culture of donation capable of transforming pain into new life.
