title: Outcome of heart transplantation in pediatric cancer survivors.
abstract: The aim of this study is to evaluate the outcome of heart transplantation in children surviving malignancies. Pediatric heart transplant recipients were identified using the UNOS database. Follow-up data including survival and rate of malignancy were analyzed. A total of 7169 children received heart transplants between 1987 and 2011. Of these, 107 (1.5%) survived previous malignancy treatment (group I) and 7062 (98.5%) did not have prior malignancy (group II). Survival after transplant was 92.5%, 90.6%, 80.3%, and 65% at three months, one, five, and 10 yr in group I, similar to the rate in group II (90.1%, 84.4%, 73.8%, and 57.7%). Survival after transplantation was similar between group I and children who underwent OHT secondary to cardiomyopathy in group II. The rate of post-OHT malignancy in group I was higher than that in group II (14/107(13%) vs. 386/7062 (5.4%), p = 0.001). Children who developed malignancy in group I had similar survival as children who developed malignancy in group II. Post-transplant survival is similar in children with and without pretransplant malignancy in spite of higher rate of malignancy in children with pretransplant malignancy. OHT appears to be a reasonable treatment option in children who develop end-stage heart disease after malignancy treatment.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Penn State University, Hershey Medical Center, Hershey, PA 17033, USA. nshah@hmc.psu.edu
authors.forename: Nishant
authors.initials: N
authors.lastname: Shah
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Aggarwal
authors.forename: Thomas
authors.initials: T
authors.lastname: L'ecuyer
mesh_terms: D009202:Cardiomyopathies / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D016208:Databases, Factual; D005260:Female; D016027:Heart Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: cardiomyopathy; heart transplant; pediatric cancer survivors