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Optimization of the Cuff Technique for Murine Heart Transplantation
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Infant heart transplantation: improved intermediate results

M B Mitchell1, D N Campbell, D R Clarke

  • 1The Department of Surgery, University of Colorado Health Sciences Center and the Children's Hospital, Denver 80262, USA.

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|August 12, 1998
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Heart transplantation in infants shows improving outcomes with experience. Prior sternotomy is a key risk factor for early infant heart transplant mortality, but survival rates are excellent.

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Area of Science:

  • Pediatric Cardiology
  • Cardiothoracic Surgery
  • Transplant Medicine

Background:

  • Infant heart transplantation is a complex procedure with significant early mortality risks.
  • Prior surgical history, such as sternotomy, may impact outcomes in infant heart transplantation.
  • Experience and evolving surgical techniques can influence the success rates of infant heart transplants.

Purpose of the Study:

  • To review the center's experience with heart transplantation in infants under six months of age.
  • To identify risk factors associated with 30-day mortality following infant heart transplantation.
  • To compare outcomes between the early and recent phases of the study period.

Main Methods:

  • Analysis of infant heart transplant recipients listed before September 1996.
  • Comparison of early versus recent halves of the patient cohort.
  • Univariate and multivariable analyses to identify risk factors for 30-day mortality.
  • Kaplan-Meier survival analysis and log-rank testing for survival comparisons.

Main Results:

  • Overall 30-day mortality was 18%, with a significant decrease from 30% in the early period to 10% in the recent period (p=0.07).
  • Prior sternotomy (p=0.01) was identified as an independent risk factor for 30-day mortality.
  • Actuarial survival rates at 1, 2, and 3 years were 80%, 78%, and 70%, respectively, showing improvement over time (p=0.05).

Conclusions:

  • Infant heart transplant outcomes have improved with accumulated surgical experience.
  • Prior sternotomy is a significant risk factor that increases early mortality.
  • Intermediate-term survival for infants undergoing heart transplantation for end-stage heart disease is favorable.