Maintenance Steroid Use and Outcomes of Pediatric Heart Transplantation: A Propensity Matched Analysis of the Pediatric Heart Transplant Study (PHTS) Database

Abstract

Purpose Maintenance steroid (MS) use in pediatric heart transplantation (HT) is variable. Our purpose was to evaluate the impact of MS use on pediatric HT outcomes. Methods and Materials All patients Results A total of 1393 (64%) patients were MS+ and 785 (36%) were MS−. There were 315 MS- patients that had propensity matched MS+ controls. Kaplan Meier analysis showed no difference in graft loss ( Figure 1 ; p=0.9), graft loss due to rejection (p=0.09), or rejection (p=0.15). There was a higher incidence of RSHC in the MS- group (p=0.004), while there was a higher incidence of malignancy in the MS+ group (p=0.02). Conclusions The use of MS was not associated with enhanced graft survival after pediatric HT. MS+ patients had a higher incidence of malignancy and MS- patients had a higher incidence of RSHC. These risks should be taken into consideration when determining maintenance steroid use in institutional protocols as well as for individual patients.