Abstract
Purpose As pediatric VAD use in the US has grown, wait-list mortality for children listed for heart transplant (HT) has decreased. It is unclear whether this decrease applies to children at highest risk of waitlist mortality, specifically children supported on ECMO or a ventilator at listing. Methods and Materials All patients Results Of 5,430 children listed for HT, 647 children were listed for HT while on ECMO. The number of patients (average 59 per year) and baseline characteristics of patient on ECMO at listing did not change appreciably over the 10-year period. For all patients, overall waitlist mortality declined 44% from 25% in 2001 to 14% (P figure 1 ] Conclusions While overall pediatric heart transplant waitlist mortality has improved significantly for US children in the past decade, waitlist mortality for the sickest children listed from ECMO or mechanical ventilation has not changed. Further research is needed to understand why the sickest patients do not appear to be benefiting from recent advances in circulatory support and refinements in organ allocation.
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