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Impact of mechanical circulatory support on survival in pediatric heart transplantation

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Marcos-Alonso S
  • Gil N
  • García-Guereta L
  • Albert D
  • Tejero MÁ
  • Perez-Villa F
  • Bueno, MG
  • Peiro, TB
  • Molina, BD
  • Sousa, DR

Abstract

Evidence on the impact of MCS on pediatric heart transplant survival is still scarce related to congenital heart disease patients including univentricular physiology as well as the risk factors for complications. We performed a retrospective review of all urgent pediatric (aged <= 16 years) HT from 2004 to 2014 in the Spanish Pediatric Heart Transplant Registry Group. Patients were stratified into two groups: urgent 0 (MCS at HT) and urgent 1 (non-MCS at HT). The primary outcome measure was post-transplant survival; secondary outcome measures were complications and absence of infections and rejection during the first post-transplant year. One hundred twenty-one pediatric patients underwent urgent HT, 58 (47.9%) urgent 0 and 63 (52%) urgent 1. There were 30 (24.8%) deaths: 12 in the urgent 0 group and 18 in the urgent 1 group, P = n.s. Regarding the type of MCS, patients on ECMO had the highest rate of complications (80%) and mortality (40%). Patients in the urgent 1 group showed a higher risk of hospital re-admission for infection during the first year after transplantation (OR 2.31 [1.1-4.82]), P = .025. We did not identify a risk factor for mortality. MCS does not impact negatively on survival after HT. However, there is a significant increase in 30-day and 1-year mortality and complications in ECMO patients compared with VAD patients. Infants, congenital heart disease, and PediMACS were not found to be risk factors for mortality.

Datos de la publicación

ISSN/ISSNe:
1397-3142, 1399-3046

PEDIATRIC TRANSPLANTATION  WILEY-BLACKWELL

Tipo:
Article
Páginas:
-
Factor de Impacto:
0,457 SCImago ℠
Cuartil:
Q2 SCImago ℠

Citas Recibidas en Web of Science: 6

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Keywords

  • bridge to heart transplant; mechanical circulatory support; pediatrics

Proyectos asociados

ENSAYO INTERNACIONAL PEDIÁTRICO EN TUMOR HEPÁTICO.

Investigador Principal: ANTONIO JUAN RIBELLES

RG_15-114 . 2018

FASE 1B DE CRIZOTINIB EN COMBINACIÓN O COMO AGENTE ÚNICO EN PACIENTES PEDIÁTRICOS CON TUMORES MALIGNOS POSITIVOS PARA ALK, ROS1 O ME.

Investigador Principal: ADELA CAÑETE NIETO

ITCC 053 . 2020

ENSAYO CLINICO ALEATORIZADO, INTERNACIONAL A DOBLE CIEGO QUE EVALUA LA EFICACIA Y SEGURIDAD DE CLOPIDOGREL 0,2 MG/KG UNA VEZ AL DIA VERSUS PLACEBO EN NEONATOS Y NIÑOS CON CARDIOPATIA CONGENITA CIANOSANTE PALIDA CON DERIVACION SISTEMATICA A LA ARTERIA PULMONAR (P.E. DERIVACION BLALOCK TAUSSING MODIFICADA).

Investigador Principal: ANA CANO SÁNCHEZ

EFC5314

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