Introduction: Heart transplantation is used to treat heart failure. The first human-to-human heart transplant took place in South Africa in 1967. However, this surgical technique is not practiced in sub-Saharan Africa, but heart failure is clearly increasing in the young and active African populations. We report the case of 03 heart transplants successfully performed in the pediatric cardiac surgery department at Seoul National University Hospital. Objective: To present heart transplantations for congenital heart disease in order to reproduce them technically in sub-Saharan Africa. Casesseries:Case1: Male, 3 years old. Background: main pulmonary artery (MPA) banding, Ventricular Septal defect (VSD) closure, Heart failure requiring left ventricular assist device (LVAD) implantation. Echocardiography: left ventricle dysfunction (EF 28%), Heart transplantation. The immediate postoperative follow-up was simple. Case2: Male, 9 years old. Background: Dilated cardiomyopathy (DCMP), Left ventricular assist Device (LVAD) implantation. Echocardiography: Severe LV dysfunction, global akinesia, LV FS/EF 10.4/22.4% (PLAX). Heart transplantation. The immediate postoperative follow-up was simple. Case3: Male, 20 years old. Background: dilated cardiomyopathy (DCMP), Duchenne Muscular Dystrophy (DMD), Left ventricular assisted device (L-VAD) (HeartMate 3) implantation. Echocardiography: Aggravated LV dysfunction (EF 26% - 29%). Heart transplantation. The immediate postoperative follow-up was simple. Conclusion: Heart transplantation according to the bi-caval procedure has made it possible to treat children with end-stage heart failure at Seoul National University Hospital. End-stage heart failure in Africa is clearly increasing among the young working population. Although Africa faces a range of challenges, heart transplantation is reproducible in sub-Saharan Africa.
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