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Outcome of pediatric heart transplantation recipients treated with ventricular assist device

Timo Jahnukainen1, Paula Rautiainen, Ilkka P Mattila

  • 1Department of Pediatrics, Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. timo.jahnukainen@helsinki.fi

Pediatric Transplantation
|November 30, 2012
PubMed

Insights

Pediatric heart transplant (HTx) patients using a ventricular assist device (VAD) before surgery showed similar long-term outcomes compared to those without VAD support. This includes graft function, rejection rates, and developmental progress.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Transplantation Medicine

Background:

  • Ventricular assist devices (VADs) are increasingly used to support pediatric patients awaiting heart transplantation (HTx).
  • Long-term outcomes for VAD-bridged pediatric HTx patients require further evaluation.

Purpose of the Study:

  • To assess the long-term prognosis of pediatric patients undergoing heart transplantation after VAD support.
  • To compare outcomes between VAD-bridged HTx patients and a control group without prior VAD use.

Main Methods:

  • Retrospective analysis of clinical data from six pediatric patients bridged to HTx with a Berlin Heart EXCOR VAD.
  • Comparison of graft function, rejection episodes, coronary artery vasculopathy, growth, and cognitive development with age-, gender-, and diagnosis-matched HTx patients.

Main Results:

  • Median follow-up of 4.5 years post-HTx showed no significant differences in graft function, rejection, or coronary artery vasculopathy between VAD-bridged and control groups.
  • Growth and cognitive development were comparable between the two groups.
  • One patient in each group developed a positive donor-specific antibody (DSA) titer post-HTx.

Conclusions:

  • VAD support prior to pediatric heart transplantation does not appear to negatively impact long-term prognosis.
  • Outcomes for VAD-bridged pediatric HTx patients are comparable to those of non-VAD bridged patients.

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