Introduction .– Rejection following cardiac transplant remains an important cause of morbidity and mortality as well as the complications of the immunosuppressive therapy. Thus, surveillance of paediatric heart transplant patients is crucial to prevent these risks or, at least, to allow an early treatment. However, only few international guidelines have been established concerning the modalities of this monitoring.

Aims .– To collect and to compare the different practices of paediatric heart transplant surveillance in France.

Patients and methods.– It was a descriptive multicenter study. Each French paediatric cardiologic centres was contacted by e-mail to complete an electronic questionnaire.

Results.– Eight centres were involved in the surveillance (including seven centres performing paediatric heart transplantation) of these patients. The average number of followed patients was 16.1 (2–50) per centre. The average number of involved physicians was 3.7 (1–8) including 38% of paediatric cardiologists. Only two centres had a devoted nurse for this activity. Echocardiography was considered to be reliable for the early detection of transplant rejection by 57% of centres. Isovolumic relaxation time was always collected. Whereas TM measurements were frequently analyzed, other Doppler measurements were inconsistently reported. Myocardial strain analysis (using speckle tracking method) was almost never performed (14%). Coronarography was systematically performed in 43%, coronary CT angiogram in 28% and cardiac MRI in 14%. For patients aged above 1 year, cardiac biopsies were systematically performed in 86%. The prevention of the transplant coronary artery disease was conducted using pravastatin in 86%, aspirin in 28% and clopidogrel in 14%.

Conclusion.– The French practices for the monitoring of paediatric heart transplant patients are heterogeneous due to the absence of national guidelines. This study highlights the need for a national register to establish consensuses for the management of these patients.