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Survival Outcomes of Oversized Cardiac Allografts in Pediatric Patients-A Single-Center Experience in Taiwan

M Ting1, C-I Tsao1, C-H Wang1

  • 1Department of Surgery, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan.

Transplantation Proceedings
|November 8, 2018
PubMed

Insights

Oversized cardiac allografts in pediatric heart transplant recipients did not negatively impact survival outcomes. This study found no significant difference in short-term or long-term survival for children receiving larger donor hearts.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Transplantation Immunology

Background:

  • The shortage of pediatric donor hearts often necessitates the use of oversized cardiac allografts.
  • Previous studies suggested potential negative impacts of oversized allografts on survival outcomes.

Purpose of the Study:

  • To evaluate the survival outcomes of pediatric patients undergoing cardiac transplantation in relation to the donor-recipient weight ratio.
  • To determine if oversized cardiac allografts affect short-term and long-term survival in children.

Main Methods:

  • A retrospective analysis of 28 children (3 months to 17 years) with dilated cardiomyopathy who underwent primary cardiac transplantation.
  • Patients were categorized into two groups based on donor-recipient weight ratio: <2.5 (n=19) and ≥2.5 (n=9).

Main Results:

  • Both groups demonstrated 100% 30-day survival.
  • 1-year survival was 95% vs 100%, 5-year survival was 84% vs 89%, and 10-year survival was 73% vs 61% for the respective groups.
  • Median survival was 14.4 years for the group with a ratio <2.5 and 12.9 years for the group with a ratio ≥2.5 (P=.6313).

Conclusions:

  • The use of oversized cardiac allografts in pediatric patients with dilated cardiomyopathy did not adversely affect short-term or long-term survival in this cohort.
  • These findings suggest that oversized allografts can be safely utilized when donor heart availability is limited.
Abstract

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