Impact of prolonged waiting times of neonates awaiting heart transplantation.
OBJECTIVE
This study analyzed waiting times and outcomes of neonates listed for heart transplantation at two medical centers from 1991 through 1994.


METHODS
Retrospective analysis was performed to examine waiting times, charges, morbidity, and outcomes.


RESULTS
Of the 30 neonates listed for transplantation, 15 received hearts, with 10 late survivors. Waiting time increased from 25 +/- 8 days in 1991 and 1992 to 58 +/- 7 days in 1993 and 1994 (p < 0.01), and the hospital charge per patient increased from $118,300 +/- $31,500 to $198,700 +/- $25,400 (p < 0.05). Freedom from sepsis predicted receiving heart transplantation (p < 0.01). Lack of a preoperative central intravenous catheter, no preoperative mechanical ventilation, and A-negative blood type predicted heart transplantation survival (p < 0.05). The chances of receiving and surviving transplantation were the same in the two periods. There was a trend toward greater morbidity among neonates waiting more than 35 days.


CONCLUSIONS
Waiting times and charges have increased significantly over the last 4 years. Patients who are free of sepsis, lack a preoperative central intravenous catheter, are not mechanically ventilated preoperatively, and have A-negative blood type have better outcomes.
Sable
C A
CA
Department of Pediatric Cardiology, Children's National Medical Center, Washington, D.C., USA.
Shaddy
R E
RE
Suddaby
E C
EC
Hawkins
J A
JA
Sell
J E
JE
Martin
G R
GR
D006085:Graft Survival; D006330:Heart Defects, Congenital / Q000191:economics / Q000453:epidemiology / Q000601:surgery*; D016027:Heart Transplantation / Q000191:economics / Q000401:mortality; D017722:Hospital Charges / Q000639:trends; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D009017:Morbidity; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution; D016896:Treatment Outcome; D014850:Waiting Lists