Fatal cardiac arrest in pediatric heart transplant recipients: Query of the UNOS database. (10th December 2017)

• Record Type: Journal Article
• Authors: Loar, Robert W.; Denfield, Susan W.; Morris, Shaine A.; Tunuguntla, Hari P.; Cabrera, Antonio G.; Price, Jack F.; Zhang, Wei; Hosek, Katherine; Kim, Jeffrey J.; Dreyer, William J.; Jeewa, Aamir
• Is Part Of: Pediatric transplantation. Volume 22:Number 1(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-12-10
• Subjects: CA -- CAV -- heart transplant -- PM -- pediatric; Transplantation of organs, tissues, etc. in children -- Periodicals; 617.95408305
• DOI: 10.1111/petr.13094
• Languages: English
• ISSNs: 1397-3142

Abstract

Abstract: The incidence of death by CA after PHTx is unknown. We aimed to determine the incidence and factors for fatal CA after PHTx, and whether a PM affects survival. Retrospective cohort study utilizing the United Network of Organ Sharing registry of patients transplanted ≤18 years. Multivariable analyses in hazard‐function domain and Kaplan‐Meier analyses were performed for an outcome of death due to CA. There were 7719 PHTx patients queried. CA was the reported cause of death in 11%. Age ≥13 years at time of transplant, presence of a PM, and depressed EF were identified as significant factors for fatal CA. Death due to CA beyond 10 years post‐transplant was associated with depressed EF, CAV, and presence of a PM. Kaplan‐Meier analysis demonstrated higher likelihood of fatal CA in patients with CAV and in those with a PM vs those without. In total, 15% of patients with a PM died from CA. CA is a relatively common cause of death after PHTx. The benefit of a PM remains unclear, but its presence does not confer complete protection. Patients with associated factors warrant vigilant surveillance and consideration for retransplantation.