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Published on: June 23, 2014
Transplant Survival After Berlin Heart EXCOR Support
Roosevelt Bryant1, Farhan Zafar, Chesney Castleberry
1From the *Division of Cardiac Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; †University of Cincinnati College of Medicine, Cincinnati, Ohio; ‡Division of Cardiology, St. Louis Children's Hospital Medical Center, St. Louis, Missouri; and §Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
The Berlin Heart EXCOR pediatric ventricular assist device (VAD) provides effective bridge to cardiac transplantation (BTT) in children. Post-transplant survival for pediatric patients using the EXCOR VAD is comparable to those without mechanical circulatory support.
Area of Science:
- Pediatric Cardiology
- Transplantation Medicine
- Medical Devices
Background:
- The Berlin Heart EXCOR pediatric ventricular assist device (VAD) is FDA-approved for bridge to transplantation (BTT) in children.
- Evaluating long-term clinical outcomes and post-transplant survival is crucial for pediatric VADs.
Purpose of the Study:
- To compare post-transplant survival in pediatric heart transplant recipients who used the EXCOR VAD for BTT versus those without pre-transplant mechanical circulatory support (no-MCS).
Main Methods:
- Retrospective analysis of the UNOS database (2004-2014) for pediatric orthotopic heart transplantation (OHT) patients (<18 years).
- Identified patients undergoing BTT with the EXCOR VAD and matched them with a control cohort of no-MCS patients.
- Compared post-transplant survival rates (30-day, 1-year, 5-year) between the two groups.
Main Results:
- Of 2,885 pediatric OHTs, 358 used the EXCOR VAD for BTT.
- Pre-transplant characteristics, including inotrope use and end-organ function (creatinine, bilirubin), were similar between the EXCOR and no-MCS cohorts.
- Kaplan-Meier survival analysis showed no significant difference in 30-day, 1-year, or 5-year post-transplant survival between the EXCOR cohort (94%, 90%, 72%) and the no-MCS cohort (98%, 91%, 77%; p=0.160).
Conclusions:
- The EXCOR Pediatric VAD as a BTT strategy in children demonstrates equivalent short- and mid-term post-transplant survival compared to OHT without pre-transplant mechanical circulatory support.
- These findings support the use of the EXCOR VAD in pediatric BTT, highlighting comparable outcomes to non-supported patients.
