Outcome of cardiac transplantation in children

Survival in a contemporary multi-institutional experience

Robert E. Shaddy, David C. Naftel, James K. Kirklin, Gerard Boyle, David C. McGiffin, Jeffrey Towbin, W. Steves Ring, Bennett Pearce, Linda Addonizio, W. Robert Morrow

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Background: Meaningful analysis of survival and risk factors for death in children who undergo heart transplantation is problematic because of the small number of heart transplantations performed at individual institutions. Methods and Results: To more accurately examine survival and risk factors for death in children undergoing heart transplantation, we analyzed 191 patients between 1 and 18 years old who received transplants at 22 centers in the Pediatric Heart Transplant Study between January 1, 1993, and December 31, 1994. Cardiac diagnosis was congenital heart disease in 74 patients (39%), dilated cardiomyopathy in 73 (38%), and other in 44 (23%). Actuarial survival was 93% at 1 month, 82% at 1 year, and 81% at 2 years after transplantation. The major causes of death (n=31) were rejection (29% of deaths), early graft failure (19%), infection (16%), sudden death (13%), and other causes (23%). By multivariate analysis, risk factors for death were assist devices (P=.02), nonidentical ABO blood types (P=.05), and younger age (P=.10). Conclusions: Contemporary survival for pediatric heart transplant recipients ≤1 year old is comparable to survival after adult heart transplantation. Risk factors for death are the need for assist devices, nonidentical ABO blood types, and younger age. Rejection is the most common cause of death after pediatric heart transplantation.

Original languageEnglish (US)
JournalCirculation
Volume94
Issue number9 SUPPL.
StatePublished - Nov 1 1996

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Heart Transplantation
Survival
Pediatrics
Transplants
Cause of Death
Equipment and Supplies
Dilated Cardiomyopathy
Survival Analysis
Sudden Death
Heart Diseases
Multivariate Analysis
Transplantation
Infection

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Shaddy, R. E., Naftel, D. C., Kirklin, J. K., Boyle, G., McGiffin, D. C., Towbin, J., ... Morrow, W. R. (1996). Outcome of cardiac transplantation in children: Survival in a contemporary multi-institutional experience. Circulation, 94(9 SUPPL.).

Outcome of cardiac transplantation in children : Survival in a contemporary multi-institutional experience. / Shaddy, Robert E.; Naftel, David C.; Kirklin, James K.; Boyle, Gerard; McGiffin, David C.; Towbin, Jeffrey; Ring, W. Steves; Pearce, Bennett; Addonizio, Linda; Morrow, W. Robert.

In: Circulation, Vol. 94, No. 9 SUPPL., 01.11.1996.

Research output: Contribution to journalArticle

Shaddy, RE, Naftel, DC, Kirklin, JK, Boyle, G, McGiffin, DC, Towbin, J, Ring, WS, Pearce, B, Addonizio, L & Morrow, WR 1996, 'Outcome of cardiac transplantation in children: Survival in a contemporary multi-institutional experience', Circulation, vol. 94, no. 9 SUPPL..
Shaddy RE, Naftel DC, Kirklin JK, Boyle G, McGiffin DC, Towbin J et al. Outcome of cardiac transplantation in children: Survival in a contemporary multi-institutional experience. Circulation. 1996 Nov 1;94(9 SUPPL.).
Shaddy, Robert E. ; Naftel, David C. ; Kirklin, James K. ; Boyle, Gerard ; McGiffin, David C. ; Towbin, Jeffrey ; Ring, W. Steves ; Pearce, Bennett ; Addonizio, Linda ; Morrow, W. Robert. / Outcome of cardiac transplantation in children : Survival in a contemporary multi-institutional experience. In: Circulation. 1996 ; Vol. 94, No. 9 SUPPL.
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N2 - Background: Meaningful analysis of survival and risk factors for death in children who undergo heart transplantation is problematic because of the small number of heart transplantations performed at individual institutions. Methods and Results: To more accurately examine survival and risk factors for death in children undergoing heart transplantation, we analyzed 191 patients between 1 and 18 years old who received transplants at 22 centers in the Pediatric Heart Transplant Study between January 1, 1993, and December 31, 1994. Cardiac diagnosis was congenital heart disease in 74 patients (39%), dilated cardiomyopathy in 73 (38%), and other in 44 (23%). Actuarial survival was 93% at 1 month, 82% at 1 year, and 81% at 2 years after transplantation. The major causes of death (n=31) were rejection (29% of deaths), early graft failure (19%), infection (16%), sudden death (13%), and other causes (23%). By multivariate analysis, risk factors for death were assist devices (P=.02), nonidentical ABO blood types (P=.05), and younger age (P=.10). Conclusions: Contemporary survival for pediatric heart transplant recipients ≤1 year old is comparable to survival after adult heart transplantation. Risk factors for death are the need for assist devices, nonidentical ABO blood types, and younger age. Rejection is the most common cause of death after pediatric heart transplantation.

AB - Background: Meaningful analysis of survival and risk factors for death in children who undergo heart transplantation is problematic because of the small number of heart transplantations performed at individual institutions. Methods and Results: To more accurately examine survival and risk factors for death in children undergoing heart transplantation, we analyzed 191 patients between 1 and 18 years old who received transplants at 22 centers in the Pediatric Heart Transplant Study between January 1, 1993, and December 31, 1994. Cardiac diagnosis was congenital heart disease in 74 patients (39%), dilated cardiomyopathy in 73 (38%), and other in 44 (23%). Actuarial survival was 93% at 1 month, 82% at 1 year, and 81% at 2 years after transplantation. The major causes of death (n=31) were rejection (29% of deaths), early graft failure (19%), infection (16%), sudden death (13%), and other causes (23%). By multivariate analysis, risk factors for death were assist devices (P=.02), nonidentical ABO blood types (P=.05), and younger age (P=.10). Conclusions: Contemporary survival for pediatric heart transplant recipients ≤1 year old is comparable to survival after adult heart transplantation. Risk factors for death are the need for assist devices, nonidentical ABO blood types, and younger age. Rejection is the most common cause of death after pediatric heart transplantation.

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