Predictors of outcomes in children awaiting heart transplantation: an experience from a National Paediatric Heart Transplantation Programme

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
William Y ShiIgor E Konstantinov

Abstract

The risk of mortality while awaiting heart transplantation (HT) may be greater in the setting of a smaller population and lower donor organ rates. Optimizing allocation policy and identifying the most vulnerable patients will help reduce mortality. As such, we aimed to evaluate the predictors of outcomes in patients awaiting HT as part of a National Paediatric HT Programme. Between 1988 and 2015, 200 children were listed for HT as part of a National Paediatric HT Programme. We categorized patients as experiencing one of four competing events: (i) transplant, (ii) death, (iii) delisting for clinical deterioration and (iv) delisting for clinical improvement. Comparison was made across three study eras: Era 1: 1988-95; Era 2: 1996-2005; Era 3: 2006-15. A multivariable competing risk regression analysis was performed to determine the independent predictors of transplantation and the composite event of death or delisting for clinical deterioration. Among the 200 patients listed, 60% (119/200) underwent transplantation, 22% (44/200) died on the waiting list, 7% (13/200) were delisted for clinical deterioration and 11% (21/200) were delisted due to clinical improvement, with 2% (3/200) being still active on the waiting list. The morta...Continue Reading

References

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Citations

Sep 18, 2016·Transplant International : Official Journal of the European Society for Organ Transplantation·Ivan Knezevic
May 24, 2017·Expert Review of Medical Devices·Edward BurattoIgor E Konstantinov
Mar 22, 2020·Pediatric Transplantation·Susan W DenfieldOliver Miera
Jun 10, 2018·Pediatric Transplantation·Richard Kirk, Anne I Dipchand
Oct 17, 2020·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Arun Beeman, Nagarajan Muthialu
Feb 24, 2020·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Richard KirkWarren A Zuckerman
Feb 16, 2021·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Scott R AuerbachUNKNOWN Action Learning Network Investigators

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