Related Experiment Video
Updated: Mar 26, 2026
Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure
Published on: January 16, 2026
Favorable Waitlist and Posttransplant Outcomes in Children and Adolescent Patients Supported With Durable
Insights
Pediatric centers use continuous-flow ventricular assist devices (CFVADs) in smaller children. Outcomes for these pediatric CFVAD patients, including smaller ones, are favorable for waitlist survival and post-transplant success.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Transplantation Medicine
Background:
- Pediatric centers increasingly implant durable adult continuous-flow ventricular assist devices (CFVADs) in children smaller than recommended sizes.
- Limited data exists on waitlist and posttransplant outcomes for pediatric CFVAD recipients, especially smaller children.
Purpose of the Study:
- To analyze waitlist and posttransplant outcomes in pediatric patients (≤18 years) supported with CFVADs.
- To compare outcomes based on body surface area (BSA; >1.5 vs. ≤1.5 m(2)) at the time of listing.
Main Methods:
- Analysis of the United Network of Organ Sharing and Organ Procurement and Transplantation Network registry.
- Identification of 138 pediatric patients with CFVADs at listing or transplantation.
- Stratification of patients by BSA (≤1.5 m(2) vs. >1.5 m(2)) at listing.
Main Results:
- Patients with BSA ≤1.5 m(2) were more likely to have noncardiomyopathy diagnoses and receive centrifugal-flow devices.
- No significant difference in failure-free waitlist survival between BSA groups (p = 0.99).
- Posttransplantation survival was 100% at 1 year and 88% at 5 years, with no difference by BSA group (p = 0.99).
Conclusions:
- Waitlist and posttransplant outcomes are favorable for pediatric CFVAD recipients.
- Pediatric patients with BSA ≤1.5 m(2) experience similar pre- and posttransplant outcomes compared to larger patients.
- Current practices of implanting CFVADs in smaller pediatric patients appear safe and effective.
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.
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
01:28Kidney Transplant I: Introduction
01:22Heart Failure VI: Adjunct Therapies