PMID- 32740355
OWN - NLM
STAT- MEDLINE
DCOM- 20210119
LR  - 20230920
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 66
IP  - 8
DP  - 2020 Aug
TI  - End-Stage Liver Disease Models and Outcomes in Pediatric Patients Supported With 
      Short-Term Continuous-Flow Ventricular Assist Devices.
PG  - 933-938
LID - 10.1097/MAT.0000000000001078 [doi]
AB  - Short-term continuous-flow ventricular assist devices (STCF-VADs) are 
      increasingly being utilized in pediatrics. End-stage liver disease (ELD) models 
      have been associated with outcomes in adult patients on mechanical circulatory 
      support. We sought to determine the relationship between outcomes in children on 
      STCF-VADs and three ELD models: model for end-stage liver disease-excluding 
      international normalized ratio (MELD-XI; all) and MELD-XI (> 1 year), PELD, and a 
      novel score, PedMELD-XI. All patients (< 19 years) supported with STCF-VADs, 
      between June 2009 and December 2016 were included. The MELD-XI, PELD, and 
      PedMELD-XI scores were calculated and their association with adverse events and a 
      composite measure of death, major bleeding, and neurologic dysfunction was 
      analyzed. Of 32 patients, median age was 0.57 years (interquartile range [IQR], 
      0.10-4.43), median weight was 7.15 kg (IQR, 3.68-16.53), 53.1% had congenital 
      heart disease, and 53.1% were male. In total, 78.1% patients experienced an 
      adverse event (78.1% a major bleed, 25.0% neurologic dysfunction, and 15.6% 
      death). The median MELD-XI score was 11.17 (IQR, 9.44-30.01), MELD-XI (>1 year) 
      9.44 (IQR, 9.44-24.33), PELD 6.00 (IQR, 4.00-13.75), and PedMELD-XI -14.91 (IQR, 
      -18.85 to -12.25). A higher MELD-XI for all ages (13.80 vs. 9.44, p = 0.037) and 
      less negative PedMELD-XI (-14.16 vs. -19.34, p = 0.028) scores were significantly 
      associated with bleeding and the composite outcome. PedMELD-XI was significantly 
      associated with death (-12.87 vs. -16.84, p = 0.041) while a trend was seen for 
      increased MELD-XI in all ages being associated with death (31.52 vs. 10.11, p = 
      0.051). Last, there was no association with the models and neurologic events. 
      MELD-XI and PedMELD-XI were significantly associated with major bleeding and the 
      composite endpoints with PedMELD-XI also being associated with death. These 
      results suggest that ELD models can be used to predict outcomes in this specific 
      patient population, however, further analysis in a larger population is required.
FAU - Malik, Getanshu
AU  - Malik G
AUID- ORCID: 0000-0002-0867-446
AD  - From the Faculty of Medicine and Dentistry, University of Alberta, Alberta, 
      Canada.
FAU - Pidborochynski, Tara
AU  - Pidborochynski T
AUID- ORCID: 0000-0002-9471-8966
AD  - Division of Pediatric Cardiology, University of Alberta, Alberta, Canada.
FAU - Buchholz, Holger
AU  - Buchholz H
AD  - Division of Cardiac Surgery, Mazankowski Alberta Heart Institute, Edmonton, 
      Alberta, Canada.
FAU - Freed, Darren H
AU  - Freed DH
AUID- ORCID: 0000-0002-6239-1444
AD  - Division of Pediatric Cardiac Surgery, Stollery Children's Hospital, Edmonton, 
      Alberta, Canada.
FAU - Al-Aklabi, Mohammed
AU  - Al-Aklabi M
AD  - Division of Pediatric Cardiac Surgery, Stollery Children's Hospital, Edmonton, 
      Alberta, Canada.
FAU - Bozso, Sabin J
AU  - Bozso SJ
AUID- ORCID: 0000-0001-7067-3102
AD  - Division of Cardiac Surgery, Mazankowski Alberta Heart Institute, Edmonton, 
      Alberta, Canada.
FAU - Choudhry, Swati
AU  - Choudhry S
AD  - Texas Children's Hospital.
FAU - Anand, Vijay
AU  - Anand V
AD  - Pediatric Critical Care, University of Alberta, Alberta, Canada.
FAU - Holinski, Paula
AU  - Holinski P
AUID- ORCID: 0000-0003-3341-4712
AD  - Pediatric Critical Care, University of Alberta, Alberta, Canada.
FAU - Conway, Jennifer
AU  - Conway J
AD  - Division of Pediatric Cardiology, University of Alberta, Alberta, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - End Stage Liver Disease
MH  - Female
MH  - Heart Failure/*mortality/*surgery
MH  - *Heart-Assist Devices
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Prognosis
MH  - Retrospective Studies
MH  - *Severity of Illness Index
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2020/08/03 06:00
MHDA- 2021/01/20 06:00
CRDT- 2020/08/03 06:00
PHST- 2020/08/03 06:00 [entrez]
PHST- 2020/08/03 06:00 [pubmed]
PHST- 2021/01/20 06:00 [medline]
AID - 00002480-202008000-00017 [pii]
AID - 10.1097/MAT.0000000000001078 [doi]
PST - ppublish
SO  - ASAIO J. 2020 Aug;66(8):933-938. doi: 10.1097/MAT.0000000000001078.