TY - JOUR
T1 - Pediatric Heart Transplantation Long-Term Survival in Different Age and Diagnostic Groups
T2 - Analysis of a National Database
AU - Alsaied, Tarek
AU - Khan, Muhammad S.
AU - Rizwan, Raheel
AU - Zafar, Farhan
AU - Castleberry, Chesney D.
AU - Bryant, Roosevelt
AU - Wilmot, Ivan
AU - Chin, Clifford
AU - Jefferies, John L.
AU - Morales, David L.
N1 - Publisher Copyright:
© 2017, © The Author(s) 2017.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Background: The purpose of this study was to evaluate differences in long-term survival without the influence of early mortality, and to identify factors associated with one-year conditional ten-year survival after heart transplantation (HTx) across different age and diagnostic groups. Methods: Organ Procurement and Transplant Network data from January 1990 to December 2005 were used. Cohort was divided according to age (infants [<1 year], children [>1-10 years], and adolescents [11-18 years]) and diagnosis (cardiomyopathy and congenital heart disease [CHD]). Factors associated with one-year conditional ten-year survival were identified using multivariable logistic regression and using a case–control design. Results: One-year conditional ten-year survivors included 1,790 patients compared to 1,114 patients who died after the first posttransplant year and within ten years of transplant with a median follow-up of 4.8 years. Predictors of one-year conditional ten-year survival for infants were recipient’s Caucasian race (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.3-2.7) and donor–recipient weight ratio (OR: 0.8, 95% CI: 0.6-1); for children: Caucasian race (OR: 1.6, 95% CI: 1.2-2.1), retransplantation (OR: 0.4, 95% CI: 0.2-0.6), and transplantation after the year 2000 (OR: 1.5, 95% CI: 1.1-2.1); for adolescents only Caucasian race (OR: 2.5, 95% CI: 1.9-2.3). In both CHD and cardiomyopathy, adolescents had worse survival compared to infants and children. There was an era effect with improved survival after 2000. Male gender was a predictor of survival in cardiomyopathy group. Conclusion: Predictors of one-year conditional ten-year survival varied among groups. These data and analyses provide important information that may be useful to clinicians, particularly when counseling patients and families regarding expectations of survival after pediatric HTx.
AB - Background: The purpose of this study was to evaluate differences in long-term survival without the influence of early mortality, and to identify factors associated with one-year conditional ten-year survival after heart transplantation (HTx) across different age and diagnostic groups. Methods: Organ Procurement and Transplant Network data from January 1990 to December 2005 were used. Cohort was divided according to age (infants [<1 year], children [>1-10 years], and adolescents [11-18 years]) and diagnosis (cardiomyopathy and congenital heart disease [CHD]). Factors associated with one-year conditional ten-year survival were identified using multivariable logistic regression and using a case–control design. Results: One-year conditional ten-year survivors included 1,790 patients compared to 1,114 patients who died after the first posttransplant year and within ten years of transplant with a median follow-up of 4.8 years. Predictors of one-year conditional ten-year survival for infants were recipient’s Caucasian race (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.3-2.7) and donor–recipient weight ratio (OR: 0.8, 95% CI: 0.6-1); for children: Caucasian race (OR: 1.6, 95% CI: 1.2-2.1), retransplantation (OR: 0.4, 95% CI: 0.2-0.6), and transplantation after the year 2000 (OR: 1.5, 95% CI: 1.1-2.1); for adolescents only Caucasian race (OR: 2.5, 95% CI: 1.9-2.3). In both CHD and cardiomyopathy, adolescents had worse survival compared to infants and children. There was an era effect with improved survival after 2000. Male gender was a predictor of survival in cardiomyopathy group. Conclusion: Predictors of one-year conditional ten-year survival varied among groups. These data and analyses provide important information that may be useful to clinicians, particularly when counseling patients and families regarding expectations of survival after pediatric HTx.
KW - cardiac transplantation
KW - pediatric
KW - predictors
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85055075852&partnerID=8YFLogxK
U2 - 10.1177/2150135117690096
DO - 10.1177/2150135117690096
M3 - Article
C2 - 29957123
AN - SCOPUS:85055075852
SN - 2150-1351
VL - 8
SP - 337
EP - 345
JO - World Journal for Pediatric and Congenital Heart Surgery
JF - World Journal for Pediatric and Congenital Heart Surgery
IS - 3
ER -