The Dutch national paediatric heart transplantation programme: outcomes during a 23-year period

被引:1
作者
Roest, Stefan [1 ,2 ,3 ]
van der Meulen, Marijke H. [1 ,3 ]
Van Osch-Gevers, Lennie M. [1 ,3 ]
Kraemer, Ulrike S. [1 ,3 ,4 ]
Constantinescu, Alina A. [2 ,3 ]
de Hoog, Matthijs [4 ]
Bogers, Ad J. J. C. [3 ,5 ]
Manintveld, Olivier C. [2 ,3 ]
van de Woestijne, Pieter C. [3 ,5 ]
Dalinghaus, Michiel [1 ,3 ]
机构
[1] Erasmus MC, Sophia Childrens Hosp, Univ Med Ctr Rotterdam, Dept Paediat Cardiol, Rotterdam, Netherlands
[2] Erasmus MC, Univ Med Ctr Rotterdam, Thorax Ctr, Dept Cardiol, Rotterdam, Netherlands
[3] Erasmus MC, Univ Med Ctr Rotterdam, Erasmus MC Transplant Inst, Rotterdam, Netherlands
[4] Erasmus MC, Sophia Childrens Hosp, Univ Med Ctr Rotterdam, Dept Paediat Intens Care, Rotterdam, Netherlands
[5] Erasmus MC, Univ Med Ctr Rotterdam, Dept Cardiothorac Surg, Rotterdam, Netherlands
关键词
Heart transplantation; Mortality; Children; Waiting list; INTERNATIONAL SOCIETY; 2; DECADES; WORKING FORMULATION; CHILDREN; NOMENCLATURE; MORTALITY; SUPPORT;
D O I
10.1007/s12471-022-01703-w
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Since 1998, there has been a national programme for paediatric heart transplantations (HT) in the Netherlands. In this study, we investigated waiting list mortality, survival post-HT, the incidence of common complications, and the patients' functional status during follow-up. Methods All children listed for HT from 1998 until October 2020 were included. Follow-up lasted until 1 January 2021. Data were collected from the patient charts. Survival, post-operative complications as well as the functional status (Karnofsky/Lansky scale) at the end of follow-up were measured. Results In total, 87 patients were listed for HT, of whom 19 (22%) died while on the waiting list. Four patients were removed from the waiting list and 64 (74%) underwent transplantation. Median recipient age at HT was 12.0 (IQR 7.2-14.4) years old; 55% were female. One-, 5-, and 10-year survival post-HT was 97%, 95%, and 88%, respectively. Common transplant-related complications were rejections (50%), Epstein-Barr virus infections (31%), cytomegalovirus infections (25%), post-transplant lymphoproliferative disease (13%), and cardiac allograft vasculopathy (13%). The median functional score (Karnofsky/Lansky scale) was 100 (IQR 90-100). Conclusion Children who undergo HT have an excellent survival rate up to 10 years post-HT. Even though complications post-HT are common, the functional status of most patients is excellent. Waiting list mortality is high, demonstrating that donor availability for this vulnerable patient group remains a major limitation for further improvement of outcome.
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收藏
页码:68 / 75
页数:8
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