Outcomes and risk factors for heart transplantation in children with congenital heart disease

摘要: Abstract Objective Heart transplantation in children with underlying congenital heart disease has traditionally been associated inferior outcomes. We report our single institution experience. Methods Between 1988 and 2013, 124 underwent transplantation. Competing risks analysis modeled events after (retransplantation, death without retransplantation). Multivariable regression examined risk factors affecting Results There were 76 male patients (61%); median age was 3.8 years (interquartile range, 0.6-11.5). Sixteen (13%) primary transplantation, 108 (87%) prior surgical repair/palliation. Thirty-eight (31%) had 2 ventricles, 86 (69%) a ventricle, including 33 (27%) who Fontan procedure. showed that at 10 13% of undergone retransplantation, 43% died 44% alive retransplantation. After 9 17 3 second Overall 15-year survival initial 41%. On multivariable analysis, for early-phase mortality less than 1 year (hazard ratio [HR], 7.2; 95% confidence interval [CI], 2.4-22.0; P  = .025) donor–recipient race mismatch (HR, 2.2; CI, 1.2-4.1;  = .016). Survival not affected by era, anomaly, procedure, sensitization, or pulmonary artery augmentation. Conclusions The outcomes have improved the current era. sensitization. Strategies to improve may need address selection criteria, timing, pretransplant post-transplant care. effect warrants further investigation might affect organ allocation algorithms immunosuppression management.