title: Risk factor analysis in pediatric heart transplantation.
abstract: BACKGROUND
  Steady assessment of risk factors will enable identification of patients at higher risk for post-transplant death, and may thus improve organ utilization and outcomes. In this study we aimed to identify the risk factors of mortality in pediatric heart transplantation.
  
  
  METHODS
  Between November 1989 and February 2004, there were 116 orthotopic heart transplantations performed in patients <18 years of age at our institution.
  
  
  RESULTS
  The 30-day mortality risk was 12% (dilated cardiomyopathy 7%, congenital heart disease 26%; univariate analysis: p = 0.023). The main cause of 30-day mortality was primary graft failure (36%). The late mortality rate was 31 per 1,000 person-years. The main causes of late mortality were acute rejection (44%) and cardiac allograft vasculopathy (26%). The 1-, 5-, 10- and 15-year survival rates were 85%, 77%, 65% and 53%, respectively. Male donor (odds ratio [OR] 6.33, 95% confidence interval [CI] 1.11 to 36.01) and cardiopulmonary bypass >210 minutes (OR 43.05, 95% CI 1.11 to 1,669) were risk factors for 30-day mortality. Risk factors for 1- and 5-year mortality were body weight ratio <0.8 (OR 40.36, 95% CI 3.04 to 536.47) and male donor (OR 3.36, 95% CI 1.05 to 10.75), respectively. Recipient age <1 year (OR 64.65, 95% CI 1.69 to 2,466.77) and donor-recipient body surface area mismatch of <0.9 (OR 10.58, 95% CI 1.03 to 108.25) were risk factors for 10-year mortality.
  
  
  CONCLUSIONS
  Pediatric heart transplantation can be performed with an expectation of excellent results. Certain risk factors suggest poorer outcomes.
authors: Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine Westphalia, University Hospital of Bochum, Bad Oeynhausen, Germany. ystjang@hotmail.com
authors: Yanto Sandy
authors: YS
authors: Tjang
authors: Hans
authors: H
authors: Stenlund
authors: Gero
authors: G
authors: Tenderich
authors: Lech
authors: L
authors: Hornik
authors: Andreas
authors: A
authors: Bairaktaris
authors: Reiner
authors: R
authors: Körfer
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001835:Body Weight; D002311:Cardiomyopathy, Dilated / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003327:Coronary Disease / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000401:mortality; D006330:Heart Defects, Congenital / Q000601:surgery; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors