Changing Patterns of Bridging to Heart Transplantation in Children

Jane Cassidy, Simon Haynes, Richard Kirk, David Crossland, Jonathan Hayden Smith, Leslie Hamilton, Massimo Griselli, Asif Hasan

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: Mechanical support as a bridge to cardiac transplantation in children is an accepted treatment. With improved devices and increasing experience, the length of time that children can be supported has increased. Donor organs remain scarce and there is significant associated morbidity. Methods: Retrospective review of all children offered mechanical support as a bridge to heart transplant over 10 years in one of the two UK pediatric heart transplant centers. Outcomes during the years 1998 to 2002 were compared with outcomes during the years 2003 to 2007. Results: Forty children in 41 separate patient episodes received mechanical support as a bridge to transplantation or, in 1 case, to recovery. Survival to transplant or recovery was achieved in 29 of 41 (71%); 26 of 40 children (63%) survived to hospital discharge. Devices used were extracorporeal membrane oxygenation (ECMO), the Medos HIAA, the Berlin Heart (from November 2005) and the Levitronix ventricular assist device (VAD) from 2007. All 3 children supported with the Levitronix survived to transplant (median duration of support 10 days). Ten of 13 children (77%) supported by the Berlin Heart survived to transplant or recovery (median duration of support 44 days). Four of 7 (57%) children supported using the Medos device survived to transplant (median duration of support 7 days). Neurologic events were the most common cause of death in both eras (1998 to 2002 and 2003 to 2008). Conclusions: Waiting times to pediatric cardiac transplant in the UK have increased. The Berlin Heart allows children to be bridged to transplant over long periods. Neurologic morbidity remains as a major concern.

Original languageEnglish (US)
Pages (from-to)249-254
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2009

Fingerprint

Heart Transplantation
Transplants
Berlin
Equipment and Supplies
Nervous System
Pediatrics
Morbidity
Extracorporeal Membrane Oxygenation
Heart-Assist Devices
Cause of Death
Transplantation
Tissue Donors
Survival

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Cite this

Cassidy, J., Haynes, S., Kirk, R., Crossland, D., Smith, J. H., Hamilton, L., ... Hasan, A. (2009). Changing Patterns of Bridging to Heart Transplantation in Children. Journal of Heart and Lung Transplantation, 28(3), 249-254. https://doi.org/10.1016/j.healun.2008.11.912

Changing Patterns of Bridging to Heart Transplantation in Children. / Cassidy, Jane; Haynes, Simon; Kirk, Richard; Crossland, David; Smith, Jonathan Hayden; Hamilton, Leslie; Griselli, Massimo; Hasan, Asif.

In: Journal of Heart and Lung Transplantation, Vol. 28, No. 3, 01.03.2009, p. 249-254.

Research output: Contribution to journalArticle

Cassidy, J, Haynes, S, Kirk, R, Crossland, D, Smith, JH, Hamilton, L, Griselli, M & Hasan, A 2009, 'Changing Patterns of Bridging to Heart Transplantation in Children', Journal of Heart and Lung Transplantation, vol. 28, no. 3, pp. 249-254. https://doi.org/10.1016/j.healun.2008.11.912
Cassidy, Jane ; Haynes, Simon ; Kirk, Richard ; Crossland, David ; Smith, Jonathan Hayden ; Hamilton, Leslie ; Griselli, Massimo ; Hasan, Asif. / Changing Patterns of Bridging to Heart Transplantation in Children. In: Journal of Heart and Lung Transplantation. 2009 ; Vol. 28, No. 3. pp. 249-254.
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