A longer waiting game: Bridging children to heart transplant with the Berlin Heart EXCOR device - The United Kingdom experience

Jane Cassidy; Troy Dominguez; Simon Haynes; Michael Burch; Richard Kirk; Aparna Hoskote; Jon Smith; Matthew Fenton; Massimo Griselli; Tain Yen Hsia; Lee Ferguson; Carin Van Doorn; Asif Hasan; Ann Karimova

doi:10.1016/j.healun.2013.08.003

A longer waiting game: Bridging children to heart transplant with the Berlin Heart EXCOR device - The United Kingdom experience

Jane Cassidy, Troy Dominguez, Simon Haynes, Michael Burch, Richard Kirk, Aparna Hoskote, Jon Smith, Matthew Fenton, Massimo Griselli, Tain Yen Hsia, Lee Ferguson, Carin Van Doorn, Asif Hasan, Ann Karimova

Research output: Contribution to journal › Article › peer-review

66 Scopus citations

Abstract

Background Mechanical circulatory support (MCS) is used to support children with end-stage heart failure to heart transplant. Methods This was a retrospective cohort study of 7 years' experience with the Berlin Heart (BH) EXCOR (Berlin Heart AG, Berlin Germany) paracorporeal ventricular assist device (VAD) in 2 United Kingdom (UK) pediatric heart transplant centers and the effect of this program on the UK pediatric heart transplant service. Results Of 102 children who received BH support, 84% survived to transplant or BH explant and 81% survived to discharge. Neither age nor duration of support influenced outcome. Stroke, ongoing requirement for ventilation while on BH, and diagnosis other than dilated cardiomyopathy were the only independent mortality risk factors. Children who weighed < 20 kg had significantly (p = 0.03) longer support times than bigger children. The number of children treated with a BH increased over time (p = 0.01). Currently > 50% of pediatric heart transplants are bridged with a BH; however, pediatric transplants per year have not increased significantly (p = 0.07) Conclusions BH use in the UK has allowed significant increases in the number of children with end-stage heart failure who can be successfully bridged to transplant and the length of time they can be supported. The total number of transplants has not increased.

Original language	English (US)
Pages (from-to)	1101-1106
Number of pages	6
Journal	Journal of Heart and Lung Transplantation
Volume	32
Issue number	11
DOIs	https://doi.org/10.1016/j.healun.2013.08.003
State	Published - Nov 2013

Keywords

Berlin Heart EXCOR
end stage heart failure
heart transplant
mechanical circulatory support
ventricular assist device

ASJC Scopus subject areas

Surgery
Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine
Transplantation

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10.1016/j.healun.2013.08.003

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Cassidy, J., Dominguez, T., Haynes, S., Burch, M., Kirk, R., Hoskote, A., Smith, J., Fenton, M., Griselli, M., Hsia, T. Y., Ferguson, L., Van Doorn, C., Hasan, A., & Karimova, A. (2013). A longer waiting game: Bridging children to heart transplant with the Berlin Heart EXCOR device - The United Kingdom experience. Journal of Heart and Lung Transplantation, 32(11), 1101-1106. https://doi.org/10.1016/j.healun.2013.08.003

Cassidy, J, Dominguez, T, Haynes, S, Burch, M, Kirk, R, Hoskote, A, Smith, J, Fenton, M, Griselli, M, Hsia, TY, Ferguson, L, Van Doorn, C, Hasan, A & Karimova, A 2013, 'A longer waiting game: Bridging children to heart transplant with the Berlin Heart EXCOR device - The United Kingdom experience', Journal of Heart and Lung Transplantation, vol. 32, no. 11, pp. 1101-1106. https://doi.org/10.1016/j.healun.2013.08.003

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title = "A longer waiting game: Bridging children to heart transplant with the Berlin Heart EXCOR device - The United Kingdom experience",

abstract = "Background Mechanical circulatory support (MCS) is used to support children with end-stage heart failure to heart transplant. Methods This was a retrospective cohort study of 7 years' experience with the Berlin Heart (BH) EXCOR (Berlin Heart AG, Berlin Germany) paracorporeal ventricular assist device (VAD) in 2 United Kingdom (UK) pediatric heart transplant centers and the effect of this program on the UK pediatric heart transplant service. Results Of 102 children who received BH support, 84% survived to transplant or BH explant and 81% survived to discharge. Neither age nor duration of support influenced outcome. Stroke, ongoing requirement for ventilation while on BH, and diagnosis other than dilated cardiomyopathy were the only independent mortality risk factors. Children who weighed < 20 kg had significantly (p = 0.03) longer support times than bigger children. The number of children treated with a BH increased over time (p = 0.01). Currently > 50% of pediatric heart transplants are bridged with a BH; however, pediatric transplants per year have not increased significantly (p = 0.07) Conclusions BH use in the UK has allowed significant increases in the number of children with end-stage heart failure who can be successfully bridged to transplant and the length of time they can be supported. The total number of transplants has not increased.",

keywords = "Berlin Heart EXCOR, end stage heart failure, heart transplant, mechanical circulatory support, ventricular assist device",

author = "Jane Cassidy and Troy Dominguez and Simon Haynes and Michael Burch and Richard Kirk and Aparna Hoskote and Jon Smith and Matthew Fenton and Massimo Griselli and Hsia, {Tain Yen} and Lee Ferguson and {Van Doorn}, Carin and Asif Hasan and Ann Karimova",

note = "Funding Information: J.C., S.H., and L.F. have received travel grants from the Berlin Heart Company within the last 3 years to enable attendance at overseas meetings. None of the other authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose. ",

year = "2013",

month = nov,

doi = "10.1016/j.healun.2013.08.003",

language = "English (US)",

volume = "32",

pages = "1101--1106",

journal = "Journal of Heart and Lung Transplantation",

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TY - JOUR

T1 - A longer waiting game

T2 - Bridging children to heart transplant with the Berlin Heart EXCOR device - The United Kingdom experience

AU - Cassidy, Jane

AU - Dominguez, Troy

AU - Haynes, Simon

AU - Burch, Michael

AU - Kirk, Richard

AU - Hoskote, Aparna

AU - Smith, Jon

AU - Fenton, Matthew

AU - Griselli, Massimo

AU - Hsia, Tain Yen

AU - Ferguson, Lee

AU - Van Doorn, Carin

AU - Hasan, Asif

AU - Karimova, Ann

N1 - Funding Information: J.C., S.H., and L.F. have received travel grants from the Berlin Heart Company within the last 3 years to enable attendance at overseas meetings. None of the other authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.

PY - 2013/11

Y1 - 2013/11

N2 - Background Mechanical circulatory support (MCS) is used to support children with end-stage heart failure to heart transplant. Methods This was a retrospective cohort study of 7 years' experience with the Berlin Heart (BH) EXCOR (Berlin Heart AG, Berlin Germany) paracorporeal ventricular assist device (VAD) in 2 United Kingdom (UK) pediatric heart transplant centers and the effect of this program on the UK pediatric heart transplant service. Results Of 102 children who received BH support, 84% survived to transplant or BH explant and 81% survived to discharge. Neither age nor duration of support influenced outcome. Stroke, ongoing requirement for ventilation while on BH, and diagnosis other than dilated cardiomyopathy were the only independent mortality risk factors. Children who weighed < 20 kg had significantly (p = 0.03) longer support times than bigger children. The number of children treated with a BH increased over time (p = 0.01). Currently > 50% of pediatric heart transplants are bridged with a BH; however, pediatric transplants per year have not increased significantly (p = 0.07) Conclusions BH use in the UK has allowed significant increases in the number of children with end-stage heart failure who can be successfully bridged to transplant and the length of time they can be supported. The total number of transplants has not increased.

AB - Background Mechanical circulatory support (MCS) is used to support children with end-stage heart failure to heart transplant. Methods This was a retrospective cohort study of 7 years' experience with the Berlin Heart (BH) EXCOR (Berlin Heart AG, Berlin Germany) paracorporeal ventricular assist device (VAD) in 2 United Kingdom (UK) pediatric heart transplant centers and the effect of this program on the UK pediatric heart transplant service. Results Of 102 children who received BH support, 84% survived to transplant or BH explant and 81% survived to discharge. Neither age nor duration of support influenced outcome. Stroke, ongoing requirement for ventilation while on BH, and diagnosis other than dilated cardiomyopathy were the only independent mortality risk factors. Children who weighed < 20 kg had significantly (p = 0.03) longer support times than bigger children. The number of children treated with a BH increased over time (p = 0.01). Currently > 50% of pediatric heart transplants are bridged with a BH; however, pediatric transplants per year have not increased significantly (p = 0.07) Conclusions BH use in the UK has allowed significant increases in the number of children with end-stage heart failure who can be successfully bridged to transplant and the length of time they can be supported. The total number of transplants has not increased.

KW - Berlin Heart EXCOR

KW - end stage heart failure

KW - heart transplant

KW - mechanical circulatory support

KW - ventricular assist device

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ER -

A longer waiting game: Bridging children to heart transplant with the Berlin Heart EXCOR device - The United Kingdom experience

Abstract

Keywords

ASJC Scopus subject areas

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