TY - JOUR
T1 - Heart Transplantation in Children With Down Syndrome
AU - Godown, Justin
AU - Fountain, Darlene
AU - Bansal, Neha
AU - Ameduri, Rebecca
AU - Anderson, Susan
AU - Beasley, Gary
AU - Burstein, Danielle
AU - Knecht, Kenneth
AU - Molina, Kimberly
AU - Pye, Sherry
AU - Richmond, Marc
AU - Spinner, Joseph A.
AU - Watanabe, Kae
AU - West, Shawn
AU - Reinhardt, Zdenka
AU - Scheel, Janet
AU - Urschel, Simon
AU - Villa, Chet
AU - Hollander, Seth A.
N1 - Publisher Copyright:
© 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2022/5/17
Y1 - 2022/5/17
N2 - BACKGROUND: Children with Down syndrome (DS) have a high risk of cardiac disease that may prompt consideration for heart transplantation (HTx). However, transplantation in patients with DS is rarely reported. This project aimed to collect and describe waitlist and post– HTx outcomes in children with DS. METHODS AND RESULTS: This is a retrospective case series of children with DS listed for HTx. Pediatric HTx centers were identified by their participation in 2 international registries with centers reporting HTx in a patient with DS providing detailed demographic, medical, surgical, and posttransplant outcome data for analysis. A total of 26 patients with DS were listed for HTx from 1992 to 2020 (median age, 8.5 years; 46% male). High-risk or failed repair of congenital heart disease was the most common indication for transplant (N=18, 69%). A total of 23 (88%) patients survived to transplant. All transplanted patients survived to hospital discharge with a median posttransplant length of stay of 22 days. At a median posttransplant follow-up of 2.8 years, 20 (87%) patients were alive, 2 (9%) developed posttransplant lymphoproliferative disorder, and 8 (35%) were hospitalized for infection within the first year. Waitlist and posttransplant outcomes were similar in patients with and without DS (P=non-significant for all). CONCLUSIONS: Waitlist and post-HTx outcomes in children with DS selected for transplant listing are comparable to pediatric HTx recipients overall. Given acceptable outcomes, the presence of DS alone should not be considered an absolute contrain-dication to HTx.
AB - BACKGROUND: Children with Down syndrome (DS) have a high risk of cardiac disease that may prompt consideration for heart transplantation (HTx). However, transplantation in patients with DS is rarely reported. This project aimed to collect and describe waitlist and post– HTx outcomes in children with DS. METHODS AND RESULTS: This is a retrospective case series of children with DS listed for HTx. Pediatric HTx centers were identified by their participation in 2 international registries with centers reporting HTx in a patient with DS providing detailed demographic, medical, surgical, and posttransplant outcome data for analysis. A total of 26 patients with DS were listed for HTx from 1992 to 2020 (median age, 8.5 years; 46% male). High-risk or failed repair of congenital heart disease was the most common indication for transplant (N=18, 69%). A total of 23 (88%) patients survived to transplant. All transplanted patients survived to hospital discharge with a median posttransplant length of stay of 22 days. At a median posttransplant follow-up of 2.8 years, 20 (87%) patients were alive, 2 (9%) developed posttransplant lymphoproliferative disorder, and 8 (35%) were hospitalized for infection within the first year. Waitlist and posttransplant outcomes were similar in patients with and without DS (P=non-significant for all). CONCLUSIONS: Waitlist and post-HTx outcomes in children with DS selected for transplant listing are comparable to pediatric HTx recipients overall. Given acceptable outcomes, the presence of DS alone should not be considered an absolute contrain-dication to HTx.
KW - Down syndrome
KW - health disparities
KW - heart transplantation
KW - outcomes
UR - http://www.scopus.com/inward/record.url?scp=85130643028&partnerID=8YFLogxK
U2 - 10.1161/JAHA.121.024883
DO - 10.1161/JAHA.121.024883
M3 - Article
C2 - 35574952
AN - SCOPUS:85130643028
SN - 2047-9980
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 10
M1 - e024883
ER -