Congenital Heart Surgeons' Society

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Patient Factors Associated With Failure To Receive Heart Transplant In Pediatric Population: An Analysis Of Unos Data
Dhaval Chauhan1, YoungMee Choi2, Giles Peek3, Micahel Parides1.
1Montefiore Medical Center, Bronx, NY, USA, 2New Jersey Medical School, Newark, NJ, USA, 3University of Florida, Gainesville, FL, USA.

Objective: We aimed to identify patient factors associated with failure to receive heart transplant in pediatric population in the United States

UNOS-OPTN data at time of listing was queried for patients aged < 18 years listed for isolated first-time heart transplant from year 2006 to 2018. Relevant patient factors were identified from the UNOS data, and time to transplant was the primary endpoint. Cox Proportional Hazards model was used to identify statistically significant patient factors associated with failure to transplant. Factors associated with p-value of <0.2 in univariable analysis were included in multivariable analysis.

On multivariable analysis, smaller children, ECMO support at the time of listing, presence of congenital heart disease and blood groups O, A and B compared to AB were associated with significantly reduced likelihood of receiving heart transplant (Table 1). On the other hand, children with status 1a and status 1b on waitlist, idiopathic cardiomyopathy as diagnosis at listing and certain UNOS regions were associated with increased likelihood of receiving heart transplant. Presence of ventricular assisted devices (implantable or paracorporeal), age and gender did not significantly contribute to the model.

Our study represents the largest and most comprehensive analysis of patient factors for failure to receive heart transplant on children in the United States. Further analysis of this data is currently being pursued by our group to generate a calculator to predict wait-time from listing to pediatric heart transplant.