A comprehensive strategy in donor acceptance: Impact on pediatric waitlist and heart transplant outcomes

• DOI: 10.1111/petr.13764
• Publication Date: 2020-06-14T17:33:51Z
• Authors: Nathanya Baez Her...; Richard Kirk; Ryan Davies; Maria Bano; David Sutcliffe; Timothy Pirolli; Robert Jaquiss; Susan Daneman; Ryan J. Butts
• Keywords: Single Center; Heart transplants; Clinical Practice

Abstract Significant inter‐ and intra‐center practice variability is present in pediatric donor heart acceptability. This may contribute to variation the refusal rate impact waitlist time, morbidity, mortality, transplant rates. In order reduce variability, our center developed implemented a comprehensive strategy regarding acceptance September 2017. The aim of this study was assess on time outcomes as well early post‐transplant outcomes. We performed single‐center, retrospective analysis all (<18 years) patients listed for single‐organ at from 2015 2018. Patients were divided into those before (Group 1) after implementation 2). primary end‐point time. Secondary end‐points included removal due death or clinical deterioration, refusals per patient, (graft failure, mechanical ventilation inotropic support, length hospital stay) 1‐year survival. Of 78 patients, 54 transplanted (29 Group 1), 9 removed deterioration (7 15 improvement (12 1). significantly shorter 2 (17 days, IQR 7‐53) vs 1 (90 14‐162); P = .006. number lower (1, 0‐2.2) (4, 2‐19); < .001. percentage refused donors with normal function (Left ventricular ejection fraction > 50%) (53% 84%; .001). Difference (n 2, 7% n 7, 20%, .18) did not reach statistical significance. There no difference between groups. decreased without impacting supports need approach organ within center.