Three decades of collaboration through the Pediatric Heart Transplant Society Registry: A journey through registry data with a highlight on children with single ventricle anatomy

Abstract

BackgroundThe Pediatric Heart Transplant Society (PHTS) Registry was founded 30 years ago as a collaborative effort among like‐minded providers of this novel life‐saving technique for children with end‐stage heart failure. In the intervening decades, the data from the Registry have provided invaluable knowledge to the field of pediatric heart transplantation. This report of the PHTS Registry provides a comprehensive look at the data, highlighting both the longevity of the registry and one unique aspect of the PHTS registry, allowing for exploration into children with single ventricle anatomy.MethodsThe PHTS database was queried from January 1, 1993 to December 31, 2019 to include pediatric (age < 18 years) patients listed for HT. For our analysis, we primarily analyzed patients by era. The early era was defined as children listed for HT from January 1, 1993 to December 31, 2004; middle era January 1, 2005 to December 31, 2009; and recent era January 1, 2010 to December 31, 2019. Outcomes after listing and transplant, including mortality and morbidities, are presented as unadjusted for risk, but compared across eras.ResultsSince 1993, 11 995 children were listed for heart transplant and entered into the PHTS Registry with 9755 listed during the study period. The majority of listings occurred within the most recent era. Waitlist survival improved over the decades as did posttransplant survival. Other notable changes over time include fewer patients experiencing allograft rejection or infection after transplant. Waitlist and posttransplant survival have changed dramatically in patients with single ventricle physiology and significantly differ by stage of single ventricle palliation.SummaryKey points from this PHTS Registry summary and focus on patients with single ventricle congenital heart disease in particular, include the changing landscape of candidates and recipients awaiting heart transplant. There is clear improvement in waitlist and transplant outcomes for children with both cardiomyopathy and congenital heart disease alike.

Thirty years of pediatric heart transplantation—On the way to better outcomes for all patients

“…In this issue of Pediatric Transplantation , Richmond et al, representing the Pediatric Heart Transplant Society (PHTS, formerly known as the Pediatric Heart Transplant Study), allow us to take a “look under the hood” of the vehicle of progress within the pediatric heart transplant community over the last 30 years or so. Richmond et al 2 report comprehensive outcomes of children listed for and/or undergoing heart transplantation between the formation of the clinical registry central to the PHTS in 1993 through the end of 2019. In this report, the authors present a large trove of outcomes data in pediatric heart transplant candidates and recipients.…”