title: Favorable Waitlist and Posttransplant Outcomes in Children and Adolescent Patients Supported With Durable Continuous-Flow Ventricular Assist Devices.
abstract: Pediatric centers are implanting durable adult continuous-flow ventricular assist devices (CFVADs) in children who are smaller than the industry-recommended size. Waitlist and posttransplant outcomes data in pediatric patients supported with CFVADs as a bridge to transplant are limited. We analyzed the United Network of Organ Sharing and Organ Procurement and Transplantation Network registry to identify patients aged ≤18 years with a CFVAD at the time of listing or transplantation. Patients were stratified by body surface area (BSA; >1.5 vs. ≤1.5 m(2) ) at time of listing. We identified 138 patients with a durable CFVAD during the listing period (100 with BSA >1.5 m(2) , 38 with BSA ≤1.5 m(2) ). Patients with BSA ≤1.5 m(2) were more likely to have a noncardiomyopathy diagnosis (18% vs. 4%, p = 0.007) and to be implanted with a centrifugal-flow rather than an axial-flow device (74% vs. 30%, p = 0.001). There was no difference in failure-free waitlist survival between BSA groups (p = 0.99) among patients with a CFVAD at listing. Posttransplantation survival was 100% and 88% at 1 and 5 years, respectively, for the entire cohort and did not differ by BSA group (p = 0.99). Consequently, waitlist and posttransplant outcomes are favorable for pediatric CFVAD recipients. Small patients (≤1.5 m(2) ) had pre- and posttransplant outcomes similar to those of larger patients that met the industry-recommended size for implantation.
authors: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: J
authors: J
authors: Mathew
authors: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: C R
authors: 0000-0002-8195-0694
authors: CR
authors: Villa
authors: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: D
authors: D
authors: Morales
authors: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: C
authors: C
authors: Chin
authors: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: F
authors: F
authors: Zafar
authors: The Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA.
authors: J
authors: J
authors: Rossano
authors: Integrated Solid Organ Transplantation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: M
authors: M
authors: Lake
authors: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors: A
authors: A
authors: Lorts
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: artificial organs/support devices: heart/ventricular assist devices; clinical research/practice; heart (native) function/dysfunction; heart disease: congenital; heart failure/injury; heart transplantation/cardiology; pediatrics