title: Complications related to the transplantation of thoracic organs: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.
abstract: A complication is an event or occurrence associated with a disease or a healthcare intervention, which constitutes a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after an intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to patients who have received transplantation of the heart, heart and lung(s) or lung(s). These specific definitions and terms will be used to track morbidity associated with transplantation in a common language across many separate databases. The complications of transplantation are known risks of congenital cardiac surgery. The purpose of this effort is to propose consensus definitions for post-transplant complications following cardiac surgery so that collection of such data can be standardized. Clinicians caring for patients who have had transplantation of thoracic organs will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing treatment strategies.
authors.affiliation: Division of Critical Care, University of Washington, Seattle Children's Hospital, Seattle, Washington 98105, USA. Howard.Jeffries@seattlechildrens.org
authors.forename: Howard
authors.initials: H
authors.lastname: Jeffries
authors.forename: Geoff
authors.initials: G
authors.lastname: Bird
authors.forename: Yuk
authors.initials: Y
authors.lastname: Law
authors.forename: Gil
authors.initials: G
authors.lastname: Wernovsky
authors.forename: Paul
authors.initials: P
authors.lastname: Weinberg
authors.forename: Christian
authors.initials: C
authors.lastname: Pizarro
authors.forename: Giovanni
authors.initials: G
authors.lastname: Stellin
mesh_terms: D002648:Child; D016208:Databases, Factual; D006330:Heart Defects, Congenital / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D012955:Societies, Medical; D014481:United States / Q000453:epidemiology