Changes in waiting time, need for mechanical circulatory support and outcomes in paediatric heart transplant recipients
Abstract Aims Heart transplantation is a well‐established treatment for end‐stage heart failure in paediatric patients, demonstrating excellent long‐term outcomes. Methods This retrospective study analyses 35 years of data on 244 paediatric recipients (<18 years) at a single institution from 1986...
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Wiley
2024-12-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.14917 |
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| author | Lisa‐Maria Rosenthal Annemarie Krauss Oliver Miera Friederike Danne Fatima Lunze Mi‐Young Cho Joachim Photiadis Felix Berger Katharina Schmitt |
| author_facet | Lisa‐Maria Rosenthal Annemarie Krauss Oliver Miera Friederike Danne Fatima Lunze Mi‐Young Cho Joachim Photiadis Felix Berger Katharina Schmitt |
| author_sort | Lisa‐Maria Rosenthal |
| collection | DOAJ |
| description | Abstract Aims Heart transplantation is a well‐established treatment for end‐stage heart failure in paediatric patients, demonstrating excellent long‐term outcomes. Methods This retrospective study analyses 35 years of data on 244 paediatric recipients (<18 years) at a single institution from 1986 to 2022. The analysis explores changes in diagnoses, survival, waiting times and mechanical circulatory support (MCS) over three decades (1991–2000, 2001–2010 and 2011–2020). Results Survival outcomes significantly improved over the study period, with 1‐year survival rates increasing from 79.3% (1991–2000) to 92.3% (2011–2020, P = 0.041). The median overall survival was 18.0 years, and median conditional survival to 1 year post‐transplant was 20.9 years. Survival differences were noted among age groups, with infants under 1 year of age experiencing higher early mortality, and adolescents (aged 11–17 years) facing increased long‐term risks, possibly linked to adult donor characteristics. Waiting times for heart transplantation increased, especially for younger age groups (0–5 and 6–10 years), reflecting the growing demand for donor organs. The use of MCS, including ventricular assist devices (VAD), surged, with 67% of recipients in the most recent decade receiving pre‐transplant VAD support. Importantly, despite prolonged waiting times and increased VAD use, overall survival continued to be favourable. Conclusions Early and long‐term results after paediatric heart transplantation have been continuously improving over the past decades. Despite an increased demand for donor organs and the growing reliance on VAD as bridge to transplantation, post‐transplantation survival is not compromised. |
| format | Article |
| id | doaj-art-505a5986e34a4b038e8c736c27126cdd |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-505a5986e34a4b038e8c736c27126cdd2024-12-11T01:56:59ZengWileyESC Heart Failure2055-58222024-12-011163626363510.1002/ehf2.14917Changes in waiting time, need for mechanical circulatory support and outcomes in paediatric heart transplant recipientsLisa‐Maria Rosenthal0Annemarie Krauss1Oliver Miera2Friederike Danne3Fatima Lunze4Mi‐Young Cho5Joachim Photiadis6Felix Berger7Katharina Schmitt8Department of Congenital Heart Disease‐Pediatric Cardiology Deutsches Herzzentrum der Charité Berlin GermanyDepartment of Congenital Heart Disease‐Pediatric Cardiology Deutsches Herzzentrum der Charité Berlin GermanyDepartment of Congenital Heart Disease‐Pediatric Cardiology Deutsches Herzzentrum der Charité Berlin GermanyDepartment of Congenital Heart Disease‐Pediatric Cardiology Deutsches Herzzentrum der Charité Berlin GermanyDepartment of Congenital Heart Disease‐Pediatric Cardiology Deutsches Herzzentrum der Charité Berlin GermanyDepartment of Congenital Heart Surgery Deutsches Herzzentrum der Charité Berlin GermanyDepartment of Congenital Heart Surgery Deutsches Herzzentrum der Charité Berlin GermanyDepartment of Congenital Heart Disease‐Pediatric Cardiology Deutsches Herzzentrum der Charité Berlin GermanyDepartment of Congenital Heart Disease‐Pediatric Cardiology Deutsches Herzzentrum der Charité Berlin GermanyAbstract Aims Heart transplantation is a well‐established treatment for end‐stage heart failure in paediatric patients, demonstrating excellent long‐term outcomes. Methods This retrospective study analyses 35 years of data on 244 paediatric recipients (<18 years) at a single institution from 1986 to 2022. The analysis explores changes in diagnoses, survival, waiting times and mechanical circulatory support (MCS) over three decades (1991–2000, 2001–2010 and 2011–2020). Results Survival outcomes significantly improved over the study period, with 1‐year survival rates increasing from 79.3% (1991–2000) to 92.3% (2011–2020, P = 0.041). The median overall survival was 18.0 years, and median conditional survival to 1 year post‐transplant was 20.9 years. Survival differences were noted among age groups, with infants under 1 year of age experiencing higher early mortality, and adolescents (aged 11–17 years) facing increased long‐term risks, possibly linked to adult donor characteristics. Waiting times for heart transplantation increased, especially for younger age groups (0–5 and 6–10 years), reflecting the growing demand for donor organs. The use of MCS, including ventricular assist devices (VAD), surged, with 67% of recipients in the most recent decade receiving pre‐transplant VAD support. Importantly, despite prolonged waiting times and increased VAD use, overall survival continued to be favourable. Conclusions Early and long‐term results after paediatric heart transplantation have been continuously improving over the past decades. Despite an increased demand for donor organs and the growing reliance on VAD as bridge to transplantation, post‐transplantation survival is not compromised.https://doi.org/10.1002/ehf2.14917mechanical circulatory supportpaediatric heart transplantationventricular assist devices |
| spellingShingle | Lisa‐Maria Rosenthal Annemarie Krauss Oliver Miera Friederike Danne Fatima Lunze Mi‐Young Cho Joachim Photiadis Felix Berger Katharina Schmitt Changes in waiting time, need for mechanical circulatory support and outcomes in paediatric heart transplant recipients ESC Heart Failure mechanical circulatory support paediatric heart transplantation ventricular assist devices |
| title | Changes in waiting time, need for mechanical circulatory support and outcomes in paediatric heart transplant recipients |
| title_full | Changes in waiting time, need for mechanical circulatory support and outcomes in paediatric heart transplant recipients |
| title_fullStr | Changes in waiting time, need for mechanical circulatory support and outcomes in paediatric heart transplant recipients |
| title_full_unstemmed | Changes in waiting time, need for mechanical circulatory support and outcomes in paediatric heart transplant recipients |
| title_short | Changes in waiting time, need for mechanical circulatory support and outcomes in paediatric heart transplant recipients |
| title_sort | changes in waiting time need for mechanical circulatory support and outcomes in paediatric heart transplant recipients |
| topic | mechanical circulatory support paediatric heart transplantation ventricular assist devices |
| url | https://doi.org/10.1002/ehf2.14917 |
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