Functional status of United States children supported with a left ventricular assist device at heart transplantation
| Autor: | Katsuhide Maeda, Amanda M. Hollander, Anica Bulic, Seth A. Hollander, Doff B. McElhinney, Christopher S. Almond, David N. Rosenthal, Sharon Chen, Jenna Murray, Mary Alice Gowan, Olaf Reinhartz, Yulin Zhang, John C. Dykes |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Cardiomyopathy
Dilated Male Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors Adolescent Waiting Lists medicine.medical_treatment 030204 cardiovascular system & hematology 030230 surgery Young Adult 03 medical and health sciences 0302 clinical medicine Quality of life Internal medicine medicine Humans Child Exercise Stroke Retrospective Studies Heart transplantation Transplantation business.industry Infant Dilated cardiomyopathy equipment and supplies medicine.disease United States Survival Rate Infusion group Child Preschool Ventricular assist device Cohort Quality of Life Cardiology Heart Transplantation Female Surgery Functional status Heart-Assist Devices Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Journal of Heart and Lung Transplantation. 36:890-896 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2017.02.024 |
| Popis: | As survival with pediatric left ventricular assist devices (LVADs) has improved, decisions regarding the optimal support strategy may depend more on quality of life and functional status (FS) rather than mortality alone. Limited data are available regarding the FS of children supported with LVADs. We sought to compare the FS of children supported with LVADs vs vasoactive infusions to inform decision making around support strategies.Organ Procurement and Transplant Network data were used to identify all United States children aged between 1 and 21 years at heart transplant (HT) between 2006 and 2015 for dilated cardiomyopathy and supported with an LVAD or vasoactive infusions alone at HT. FS was measured using the 10-point Karnofsky and Lansky scale.Of 701 children who met the inclusion criteria, 430 (61%) were supported with vasoactive infusions, and 271 (39%) were supported with an LVAD at HT. Children in the LVAD group had higher median FS scores at HT than children in the vasoactive infusion group (6 vs 5, p0.001) but lower FS scores at listing (4 vs 6, p0.001). The effect persisted regardless of patient location at HT (home, hospital, intensive care) or device type. Discharge by HT occurred in 46% of children in the LVAD group compared with 26% of children in the vasoactive infusion cohort (p = 0.001). Stroke was reported at HT in 3% of children in the LVAD cohort and in 1% in the vasoactive infusion cohort (p = 0.04).Among children with dilated cardiomyopathy undergoing HT, children supported with LVADs at HT have higher FS than children supported with vasoactive infusions at HT, regardless of device type or hospitalization status. Children supported with LVADs at HT were more likely to be discharged from the hospital but had a higher prevalence of stroke at HT. |
| Databáze: | OpenAIRE |
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