Moderate‐severe primary graft dysfunction after pediatric heart transplantation

Background PGD is a complication after heart transplantation (OHT) and a significant cause of mortality, particularly in infant recipients. Lack of standardized definition of PGD in the pediatric population makes the prevalence and magnitude of impact unclear. Methods ISHLT PGD consensus guidelines,...

Full description

Saved in:
Bibliographic Details
Published in:Pediatric transplantation 2019-03, Vol.23 (2), p.e13340-n/a
Main Authors: Mowers, Katie L., Simpson, Kathleen E., Gazit, Avihu Z., Eghtesady, Pirooz, Canter, Charles E., Castleberry, Chesney D.
Format: Article
Language:English
Subjects:
Graft rejection
Heart diseases
Heart surgery
Heart transplantation
Ischemia
Palliation
pediatric heart transplantation
Pediatrics
PGD
Risk factors
Survival
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background PGD is a complication after heart transplantation (OHT) and a significant cause of mortality, particularly in infant recipients. Lack of standardized definition of PGD in the pediatric population makes the prevalence and magnitude of impact unclear. Methods ISHLT PGD consensus guidelines, which include inotrope scores and need for MCS, were applied retrospectively to 208 pediatric OHT recipients from a single institution from 1/2005‐5/2016. PGD was defined as: moderate PGD—inotrope score >10 on postoperative day 1 (24‐48 hours), and severe PGD—MCS within 24 hours (in the absence of detectable rejection). Results PGD occurred in 34 patients (16.3%); 14 of which had severe PGD (6.7%). Multivariate risk factors for PGD included CPB time (OR 10.3/10 min, 95% 10.05, 10.2, P = 0.03), Fontan palliation (OR 1.9, 95% 1.2, 3.97), and PCM (OR 5.65, 95% 1.52, 22.4); but not age, weight, ischemic time, or donor characteristics. Upon sub‐analysis excluding patients with PCM, increased CPB was a significant multivariate risk factor (OR 10.09, 95% 9.89, 10.12, P = 0.003). Patients with PGD had decreased discharge survival compared to those without PGD (85% vs 96%, P 
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.13340