Early Predictors of Survival to and After Heart Transplantation in Children With Dilated Cardiomyopathy

The importance of clinical presentation and pretransplantation course on outcome in children with dilated cardiomyopathy listed for heart transplantation is not well defined. The impact of age, duration of illness, sex, race, ventricular geometry, and diagnosis of myocarditis on outcome in 261 child...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2012-08, Vol.126 (9), p.1079-1086
Main Authors: PIETRA, Biagio A, KANTOR, Paul F, KIRKLIN, James K, NAFTEL, David C, HSU, Daphne T, BARTLETT, Heather L, CHIN, Clifford, CANTER, Charles E, LARSEN, Ranae L, ERIK EDENS, R, COLAN, Steven D, TOWBIN, Jeffrey A, LIPSHULTZ, Steven E
Format: Article
Language:English
Subjects:
Age Factors
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiomyopathy, Dilated - complications
Cardiomyopathy, Dilated - mortality
Cardiomyopathy, Dilated - surgery
Cause of Death
Child
Child, Preschool
Continental Population Groups
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Female
Heart Transplantation
Heart Ventricles - diagnostic imaging
Humans
Infant
Kaplan-Meier Estimate
Male
Medical sciences
Myocarditis - complications
Postoperative Complications - mortality
Proportional Hazards Models
Respiration, Artificial
Risk Factors
Severity of Illness Index
Ultrasonography
Ventricular Dysfunction, Left - etiology
Waiting Lists
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Summary:The importance of clinical presentation and pretransplantation course on outcome in children with dilated cardiomyopathy listed for heart transplantation is not well defined. The impact of age, duration of illness, sex, race, ventricular geometry, and diagnosis of myocarditis on outcome in 261 children with dilated cardiomyopathy enrolled in the Pediatric Cardiomyopathy Registry and Pediatric Heart Transplant Study was studied. End points included listing as United Network for Organ Sharing status 1, death while waiting, and death after transplantation. The median age at the time of diagnosis was 3.4 years, and the mean time from diagnosis to listing was 0.62±1.3 years. Risk factors associated with death while waiting were ventilator use and older age at listing in patients not mechanically ventilated (P=0.0006 and P=0.03, respectively). Shorter duration of illness (P=0.04) was associated with listing as United Network for Organ Sharing status 1. Death after transplantation was associated with myocarditis at presentation (P=0.009), nonwhite race (P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.110.011999