Improving Outcomes in Children Requiring Mechanical Bridge-To-Transplantation (BTT) in the Current Era

Abstract

Purpose Bridging children to transplant with ventricular assist device (VAD) has been expanding. Little recent data exists assessing the VAD use and survival to and after heart transplantation in children. Methods and Materials UNOS provided data on 8,131 patients listed for transplant (1995-2011); they were divided into three eras: early (1995-2002, n=3804), mid (2003-2007, n=2400) and late (2008-2011, n=1937). VADs were present at listing in 375 (4.6%) and at transplant in 371 (7.1%). Outcomes among VAD patients were assessed and compared across eras. Results VAD use has increased over time (early: 3.4%, mid: 5.1%, late 7.3%, p figure 1 ] Conclusions Results with VAD bridging have improved in the current era. Post-transplant survival is unaffected by the presence of a VAD at transplant. Younger patients and those with CHD remain high-risk groups in need of better mechanical support alternatives.