Survival and quality of life for children with end-stage heart failure who are not candidates for cardiac transplant

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Arash Alen SabatiJonDavid Menteer

Abstract

Some pediatric patients referred for heart transplant (HTx) are sub-optimal candidates. Their outcomes without HTx are presumed to be dismal, but have not been well described. Knowledge about their outcomes is critical when weighing the risks between a high-risk transplant and "terminal" palliation. We retrospectively reviewed all HTx referrals from January 2005 to July 2013. We excluded those who were listed for HTx, or who were denied HTx due to being "too well," seeking only those who were in need of but not suitable for HTx. End-points included mortality and length of survival. Of 212 referrals, 39 (19%) (age 0 to 19 years, median 3.5 years) were denied HTx for reasons other than being too well. Twenty-eight (72%) had palliated congenital heart disease. Overall mortality during the follow-up period was 38% (n = 15) with a median follow-up time of 195 days (8 to 2,832 days). Ten patients received subsequent cardiac surgery with 1 death (10%) and median follow-up of 2.6 years. Mortality risk was not influenced by age, weight, growth failure, congenital heart disease or single-ventricle physiology. Mechanical ventilation (hazard ratio 6.31, p = 0.001) and inotrope dependence (hazard ratio 4.79, p = 0.006) were associated with ...Continue Reading

References

Jun 12, 2002·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Adam S BetkowskiPaul J Hauptman
Oct 30, 2004·The Annals of Thoracic Surgery·Jeffrey P JacobsGeorge R Daicoff
Jul 4, 2006·Lancet·Steven A WebberAdriana Zeevi
Feb 23, 2008·Journal of Cardiac Surgery·Yanto Sandy TjangReiner Körfer
Aug 9, 2011·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·William T MahleUNKNOWN Pediatric Heart Transplant Study Group
Sep 8, 2012·Pediatric Cardiology·JonDavid MenteerJeffrey I Gold
Jan 15, 2014·The Journal of Pediatrics·Katelyn MellionUNKNOWN Pediatric Cardiac Quality of Life Inventory Testing Study Consortium

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