[Selection and management of donor hearts in infant and pediatric heart transplantation: Loma Linda experience].

: One hundred and six infant and pediatric patients received 108 heart transplantations between November 1985 and December 1990. The age of the recipients was from 0 day to 12 years (mean 11.1 months) and the age of the donors were from 2 days to 24 years (mean 18.3 months). The body weight ratio of donor and recipient were from 59% to 315% (mean 163%). Large donor hearts were well tolerated without serious complication even in small infants. The graft ischemic time was from 51 minutes to 505 minutes (mean 244 minutes) and fifty four grafts had ischemic time more than 4 hours. There was no difference of the frequency of primary graft failure between the grafts with longer and shorter ischemic time. Although diastolic function in the first week post-transplant was more depressed in the grafts with longer ischemic time, no difference was observed after the second post-transplant week. There was no difference in the systolic function in accordance with the ischemic time. Eight hours and more ischemic time was well tolerated in our donor grafts.