Pediatric heart transplant

Barnes, Aliessa P.; Gibson, William J.

doi:10.1016/j.sempedsurg.2021.151039

Cited by 8 publications

(17 citation statements)

References 19 publications

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“…3 However, the difference in the pediatric heart transplant rate between US citizens and NCNRs is likely due to the significant difference in the background heart disease between the US citizen and NCNR groups that necessitated the transplantation. In comparing congenital heart disease with cardiomyopathy, the waitlisted patients with congenital heart disease tended to be younger and smaller, 13 which may have decreased their chances of receiving the heart transplant.…”

Section: Discussionmentioning

confidence: 99%

Heart transplantation for pediatric foreign nationals in the United States

Harano

Sheth

Sasaki

et al. 2023

Clinical Transplantation

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Background This study aimed to clarify survival outcomes, waitlist mortality, and waitlist days of heart transplantation of pediatric foreign nationals compared to pediatric United States (US) citizens. Methods We retrieved data from March 2012 to June 2021 in the United Network Organ Sharing (UNOS) registry. Results Of 5857 pediatric patients newly waitlisted, 133 (2.27%) patients were non‐US citizen/non‐US residents (non‐citizen non‐resident [NCNR]). Patients with congenital heart disease were higher in the US citizen group than in the NCNR group (51.9% vs. 22.6%, p < .001); 76.7% of patients in the NCNR group (102/133) had cardiomyopathy. Of the 133 NCNRs, 111 patients (83.5%) underwent heart transplantation, which was significantly higher than that in the US citizen group (68.6%, p < .001). The median waitlist time was 71 days (IQR, 22–172 days) in the NCNR group and 74 days (29–184 days) in the US citizen group (p = .48). Survival after heart transplant was significantly better in the NCNR group than in the US citizen group (n = 3982; logrank test p = .015). Conclusions Heart transplantation for pediatric foreign nationals was mostly indicated for cardiomyopathy, and their transplant rate was significantly higher than that in the US citizen group, with better survival outcomes. The better survival outcomes in the NCNR group compared to the US citizen group can likely be attributed to the differing diagnoses for which transplantation was performed.

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Section: Discussionmentioning

confidence: 99%

Heart transplantation for pediatric foreign nationals in the United States

Harano

Sheth

Sasaki

et al. 2023

Clinical Transplantation

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“…However, OHT necessitates lifelong immunosuppression that partial heart transplantation does not, and the shortage of donor hearts for OHT and the inability of VADs to be placed in infants and small children causes high waitlist mortality, especially among this group, a complication that could be alleviated by partial heart transplantation. 18,26 Disadvantages of partial heart transplantation include the necessity of immunosuppression that brings with it the aforementioned risks. 18,23 The amount of time children are on immunosuppressants would be shorter than in other transplants, but these risks would still be present for the duration of the therapy.…”

Section: Hill Et Al Suggest That Heart Valves Are Immune-privileged S...mentioning

confidence: 99%

“…26 Successful immunosuppression was pivotal for OHT to become a feasible clinical practice. 23,26 While immunosuppression is crucial in the management of OHT, it is also linked to substantial morbidity and mortality in pediatric OHT recipients due to its association with post-transplant lymphoproliferative disorders and malignant lymphoma. The risk of these complications is primarily increased by the post-transplant acquisition of Ebstein-Barr virus, and treatment often necessitates withdrawal of immunosuppression.…”

Section: Shortage Of Hearts For Pediatric Transplantmentioning

confidence: 99%

“…A 2020 ISHLT consensus statement published results from a survey sent to organ procurement organizations that showed the discard rate of pediatric donor hearts to be 57%. 26 This high discard rate of pediatric hearts for transplant acts only to exacerbate the existing shortage.…”

Section: Shortage Of Hearts For Pediatric Transplantmentioning

confidence: 99%

“…These risk factors are highly prevalent in infants born with CHD, and often, the small size of these patients limits the use of ventricular assist devices (VAD), an intervention that has successfully lowered the waitlist mortality for older children listed for OHT. Unsurprisingly, these factors cause infants <12 months of age to experience the highest waitlist mortality of all groups of pediatric patients listed for OHT 26 . Successful immunosuppression was pivotal for OHT to become a feasible clinical practice 23,26 .…”

Section: Surgical Options For Heart Valve Dysfunction In Neonatesmentioning

confidence: 99%

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Partial heart transplantation can ameliorate donor organ utilization

Sherard

Atteya

Vogel

et al. 2022

Journal of Cardiac Surgery

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Background The treatment of babies with unrepairable heart valve dysfunction remains an unsolved problem because there are no growing heart valve implants. However, orthotopic heart transplants are known to grow with recipients. Aim Partial heart transplantation is a new approach to delivering growing heart valve implants, which involves transplantation of the part of the heart containing the valves only. In this review, we discuss the benefits of this procedure in children with unrepairable valve dysfunction. Conclusion Partial heart transplantation can be performed using donor hearts with poor ventricular function and slow progression to donation after cardiac death. This should ameliorate donor heart utilization and avoid both primary orthotopic heart transplantation in children with unrepairable heart valve dysfunction and progression of these children to end‐stage heart failure.

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