Fatal cardiac arrest in pediatric heart transplant recipients: Query of the UNOS database.

Autor: Loar RW; Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA., Denfield SW; Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA., Morris SA; Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA., Tunuguntla HP; Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA., Cabrera AG; Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA., Price JF; Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA., Zhang W; Outcomes and Impact Service, Texas Children's Hospital, Houston, TX, USA., Hosek K; Outcomes and Impact Service, Texas Children's Hospital, Houston, TX, USA., Kim JJ; Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA., Dreyer WJ; Pediatric Cardiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA., Jeewa A; Pediatric Cardiology, The Hospital for Sick Children, Toronto, ON, Canada.
Jazyk: angličtina
Zdroj: Pediatric transplantation [Pediatr Transplant] 2018 Feb; Vol. 22 (1). Date of Electronic Publication: 2017 Dec 10.
DOI: 10.1111/petr.13094
Abstrakt: 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.
(© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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