title: Outcomes of fetal listed patients awaiting heart transplantation.
abstract: HTx in neonates is mainstay therapy for those with severe cardiomyopathies and congenital heart disease. Fetal listing for HTx has been proposed as a way to increase the potential window for a donor with outcomes predicted to be similar to the neonatal population. Data from the PHTS, a prospective multicenter study, were used to examine the outcomes of fetuses listed between 1993 and 2009. Four thousand three hundred and sixty-five children were listed for HTx during this period. Fetuses comprised 1% and neonates 19.8% of listed patients. In those patients listed as fetus and transplanted, the median wait time from listing to HTx was 55 days (range 4-255), with a median of 25 days (range 0-233) after birth. By six months post-listing, a higher proportion of fetal listed patients had undergone HTx with a lower waitlist mortality when compared with neonate. There was no significant difference in survival following HTx between the two group (p = 0.4). While the results of this study may be less applicable to current practice due to changes in referrals for fetal listing, they do indicate that fetal listing can be a reasonable option. These results are of particular interest at the present time given the ongoing public discourse on the proposed elimination of fetal listing within UNOS.
authors.affiliation: Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Conway
authors.forename: Maryanne R K
authors.initials: MR
authors.lastname: Chrisant
authors.forename: Lori J
authors.initials: LJ
authors.lastname: West
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Ameduri
authors.forename: Juan C
authors.initials: JC
authors.lastname: Alejos
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Lamour
authors.forename: Bibhuti
authors.initials: B
authors.lastname: Das
authors.forename: Deborah
authors.initials: D
authors.lastname: Gilbert
authors.forename: Margaret
authors.initials: M
authors.lastname: Tresler
authors.forename: David C
authors.initials: DC
authors.lastname: Naftel
authors.forename: Shelley D
authors.initials: SD
authors.lastname: Miyamoto
mesh_terms: D000367:Age Factors; D009202:Cardiomyopathies / Q000175:diagnosis / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D005318:Fetal Heart; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: fetus; infant; pediatric heart transplant; transplant listing