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Updated: Sep 30, 2025

Implantation of Total Artificial Heart in Congenital Heart Disease
07:27

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

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Waitlist Outcomes for Children With Congenital Heart Disease: Lessons Learned From Over 5000 Heart Transplant

Madeleine Townsend1, Tara Karamlou2, Gerard Boyle3

  • 1Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.

Journal of Cardiac Failure
|March 18, 2022
PubMed

Insights

Pediatric heart transplant waitlist survival for children with congenital heart disease (CHD) has improved over time, but outcomes remain worse than for cardiomyopathy patients. Ventricular assist device (VAD) therapy may enhance future waitlist results.

Area of Science:

  • Pediatric Cardiology
  • Transplant Surgery
  • Medical Device Technology

Background:

  • Examining pediatric heart transplant policy changes and ventricular assist device (VAD) approval impacts.
  • Assessing waitlist (WL) outcomes for children with congenital heart disease (CHD).

Purpose of the Study:

  • To evaluate the effect of evolving pediatric heart allocation policies and the Berlin VAD on WL outcomes for pediatric CHD patients.
  • To compare WL outcomes for CHD patients across different time eras and with cardiomyopathy (CMP) patients.

Main Methods:

  • Analysis of the Scientific Registry of Transplant Recipients database (1999-2019).
  • Inclusion of all pediatric patients (<18 years) with CHD and cardiomyopathy (CMP) on the WL.
  • Stratification into four eras: 1999-2008, 2009-2011, 2012-2016, and 2016-2019.

Main Results:

  • Waitlist survival for children with CHD significantly improved from Era 1 to Era 4 (P < .001).
  • Patients listed in Era 4 were less likely to be infants or on mechanical support (ventilation/ECMO) but more likely to be on a VAD compared to earlier eras.
  • Despite improvements, children with CHD in Era 4 had inferior WL survival compared to CMP patients (P < .001).

Conclusions:

  • Children with CHD are increasingly listed with less advanced heart failure, showing improved WL survival over time.
  • Pediatric WL outcomes for CHD patients remain poorer than for CMP patients.
  • Advancements in pediatric medical care and VAD technology hold promise for improving future WL outcomes.
Abstract

Keywords:
Congenital heart diseaseoutcomes researchpolicy changestransplantwaitlist survival

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