PMID- 33679060 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231110 IS - 0974-2069 (Print) IS - 0974-5149 (Electronic) IS - 0974-5149 (Linking) VI - 14 IP - 1 DP - 2021 Jan-Mar TI - Clinical profiles and risk factors for early and medium-term mortality following heart transplantation in a pediatric population: A single-center experience. PG - 42-52 LID - 10.4103/apc.APC_129_20 [doi] AB - AIMS AND OBJECTIVES: There is a paucity of data regarding the outcomes of Heart transplantation in children from the Indian subcontinent. The data of patients under the age of 18 undergoing an isolated heart transplantation was analyzed for patient clinical profiles and risk factors for early and medium-term mortality. Hospital mortality was defined as death within 90 days of transplantation and medium-term survival as follow up of up to 6 years. MATERIALS AND METHODS: A total of 97 patients operated between March 2014 and October 2019 were included in this study. Data was collected about their INTERMACS status, pulmonary vascular resistance, donor heart ischemic times, donor age, donor to recipient weight ratio and creatinine levels. RESULTS: The age range was from 1 to 18 with a mean of 10.6 +/- 4.6 years. 67 % patients were in INTERMACS category 3 or less.12 children were on mechanical circulatory support at the time of transplant. The 90 day survival was 89 %. The risk factors for hospital mortality was lower INTERMACS category (odd's ratio 0.2143, P = 0.026), elevated creatinine (odd's ratio 5.42, P = 0.076) and elevated right atrial pressure (odd's ratio 1.19, P = 0.015). Ischemic time, pulmonary vascular resistance (PVR) and PVR index (PVRI) had no effect on 90 day survival. Kaplan Meier estimates for 5 year survival was 73 %. The medium term survival was affected by INTERMACS category (Hazard ratio 0.7, P = .078), donor age > 25 (Hazard ratio 1.6, P = 0.26) and raised serum creatinine values.(Hazard ratio 2.7, P = 0.012). All the survivors are in good functional class. CONCLUSIONS: Excellent outcomes are possible after heart transplantation in a pediatric population even in a resource constrained environment of a developing economy. More efforts are needed to promote pediatric organ donation and patients need to be referred in better INTERMACS category for optimal outcomes. CI - Copyright: (c) 2021 Annals of Pediatric Cardiology. FAU - Balakrishnan, Komarakshi R AU - Balakrishnan KR AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Rao, Kemundel Genny Suresh AU - Rao KGS AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Subramaniam, Ganapathy Krishnan AU - Subramaniam GK AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Tanguturu, Murali Krishna AU - Tanguturu MK AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Arvind, Ajay AU - Arvind A AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Ramanan, Veena AU - Ramanan V AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Dhushyanthan, Jagdish AU - Dhushyanthan J AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Ramasubramanian, K AU - Ramasubramanian K AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Kumaran, K Suresh AU - Kumaran KS AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Sellamuthu, Gunalan AU - Sellamuthu G AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Rajam, Mohan AU - Rajam M AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Mettur, Senthil AU - Mettur S AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Gnansekharan, Pradeep AU - Gnansekharan P AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. FAU - Ratnagiri, Ravikumar AU - Ratnagiri R AD - Department of Pediatric Cardiac Surgery, Institute of Heart and Lung Transplantation, MGM Health Care, Chennai, Tamil Nadu, India. LA - eng PT - Journal Article DEP - 20210116 PL - India TA - Ann Pediatr Cardiol JT - Annals of pediatric cardiology JID - 101495459 PMC - PMC7918032 OTO - NOTNLM OT - Pediatric Heart transplant OT - Pediatric heart transplant India OT - pediatric heart transplant Outcomes COIS- There are no conflicts of interest. EDAT- 2021/03/09 06:00 MHDA- 2021/03/09 06:01 PMCR- 2021/01/01 CRDT- 2021/03/08 05:48 PHST- 2020/05/31 00:00 [received] PHST- 2020/07/30 00:00 [revised] PHST- 2020/11/27 00:00 [accepted] PHST- 2021/03/08 05:48 [entrez] PHST- 2021/03/09 06:00 [pubmed] PHST- 2021/03/09 06:01 [medline] PHST- 2021/01/01 00:00 [pmc-release] AID - APC-14-42 [pii] AID - 10.4103/apc.APC_129_20 [doi] PST - ppublish SO - Ann Pediatr Cardiol. 2021 Jan-Mar;14(1):42-52. doi: 10.4103/apc.APC_129_20. Epub 2021 Jan 16.