Multiple risk factors before pediatric cardiac transplantation are associated with increased graft loss

Scott R. Auerbach, Marc E. Richmond, Jonathan M. Chen, Ralph S. Mosca, Jan M. Quaegebeur, Linda J. Addonizio, Daphne T. Hsu, Jacqueline M. Lamour

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Identification of heart transplant recipients at highest risk for a poor outcome could lead to improved posttransplantation survival.A chart review of primary heart transplantations from 1993 to 2006 was performed. Analysis was performed to evaluate the risk of graft loss for those with a transplantation age less than 1 year, congenital heart disease (CHD), elevated pulmonary vascular resistance (index > 6), positive panel reactive antibody or crossmatch, liver or renal dysfunction, mechanical ventilation, or mechanical circulatory support (MCS). Primary transplantation was performed for 189 patients. Among these patients, 37% hadCHD, 23% had mechanical ventilation, and 6% had renal dysfunction. Overall graft survival was 82% at 1 year and 68% at 5 years. The univariate risk factors for graft loss included mechanical ventilation (hazard ratio [HR], 1.9; 95% confidence interval [CI], 1.15-3.18), CHD (HR, 1.68; 95% CI, 1.04-2.70), and renal dysfunction (HR, 3.05; 95% CI, 1.34-6.70). The multivariate predictors of graft loss were CHD (HR, 1.8; 95% CI, 1.02-2.64), mechanical ventilation (HR, 1.9; 95% CI, 1.13-3.10), and the presence of two or more statistically significant univariate risk factors (SRF) (HR, 3.8; 95% CI, 2.00-7.32). Mechanical ventilation, CHD, and the presence of two or more SRFs identify pediatric patients at higher risk for graft loss and should be considered in the management of children with end-stage heart failure.

Original languageEnglish (US)
Pages (from-to)49-54
Number of pages6
JournalPediatric Cardiology
Volume33
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Heart Transplantation
Artificial Respiration
Confidence Intervals
Pediatrics
Transplants
Heart Diseases
Kidney
Transplantation
Graft Survival
Vascular Resistance
Heart Failure
Survival
Antibodies
Liver

Keywords

  • Alternate listing
  • Cardiac transplantation
  • Congenital heart disease
  • Graft survival
  • Pediatrics
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Auerbach, S. R., Richmond, M. E., Chen, J. M., Mosca, R. S., Quaegebeur, J. M., Addonizio, L. J., ... Lamour, J. M. (2012). Multiple risk factors before pediatric cardiac transplantation are associated with increased graft loss. Pediatric Cardiology, 33(1), 49-54. https://doi.org/10.1007/s00246-011-0077-7

Multiple risk factors before pediatric cardiac transplantation are associated with increased graft loss. / Auerbach, Scott R.; Richmond, Marc E.; Chen, Jonathan M.; Mosca, Ralph S.; Quaegebeur, Jan M.; Addonizio, Linda J.; Hsu, Daphne T.; Lamour, Jacqueline M.

In: Pediatric Cardiology, Vol. 33, No. 1, 01.2012, p. 49-54.

Research output: Contribution to journalArticle

Auerbach, Scott R. ; Richmond, Marc E. ; Chen, Jonathan M. ; Mosca, Ralph S. ; Quaegebeur, Jan M. ; Addonizio, Linda J. ; Hsu, Daphne T. ; Lamour, Jacqueline M. / Multiple risk factors before pediatric cardiac transplantation are associated with increased graft loss. In: Pediatric Cardiology. 2012 ; Vol. 33, No. 1. pp. 49-54.
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