title: Hypoalbuminemia and poor growth predict worse outcomes in pediatric heart transplant recipients.
abstract: Children with end-stage cardiac failure are at risk of HA and PG. The effects of these factors on post-transplant outcome are not well defined. Using the PHTS database, albumin and growth data from pediatric heart transplant patients from 12/1999 to 12/2009 were analyzed for effect on mortality. Covariables were examined to determine whether HA and PG were risk factors for mortality at listing and transplant. HA patients had higher waitlist mortality (15.81% vs. 10.59%, p = 0.015) with an OR of 1.59 (95% CI 1.09-2.30). Survival was worse for patients with HA at listing and transplant (p ≤ 0.01 and p = 0.026). Infants and patients with congenital heart disease did worse if they were HA at time of transplant (p = 0.020 and p = 0.028). Growth was poor while waiting with PG as risk factor for mortality in multivariate analysis (p = 0.008). HA and PG are risk factors for mortality. Survival was worse in infants and patients with congenital heart disease. PG was a risk factor for mortality in multivariate analysis. These results suggest that an opportunity may exist to improve outcomes for these patients by employing strategies to mitigate these risk factors.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Chesney
authors.initials: C
authors.lastname: Castleberry
authors.forename: Connie
authors.initials: C
authors.lastname: White-Williams
authors.forename: David
authors.initials: D
authors.lastname: Naftel
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Tresler
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Pruitt
authors.forename: Shelley D
authors.initials: SD
authors.lastname: Miyamoto
authors.forename: Debbie
authors.initials: D
authors.lastname: Murphy
authors.forename: Robert
authors.initials: R
authors.lastname: Spicer
authors.forename: Louise
authors.initials: L
authors.lastname: Bannister
authors.forename: Kenneth
authors.initials: K
authors.lastname: Schowengerdt
authors.forename: Lisa
authors.initials: L
authors.lastname: Gilmore
authors.forename: Beth
authors.initials: B
authors.lastname: Kaufman
authors.forename: Steven
authors.initials: S
authors.lastname: Zangwill
mesh_terms: D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006130:Growth Disorders / Q000150:complications* / Q000628:therapy; D006333:Heart Failure / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications* / Q000628:therapy; D008297:Male; D015999:Multivariate Analysis; D009752:Nutritional Status; D012307:Risk Factors; D016019:Survival Analysis; D066027:Transplant Recipients; D016896:Treatment Outcome
keywords: heart transplant; hypoalbuminemia; nutrition; outcomes; pediatric; weight