Pediatric Heart Transplant Recipients Bridged with Biventricular Assist Device Have Worse One-Year Graft Survival: An Analysis of the United Network of Organ Sharing Database

Abstract

Purpose Registry data report that 15-26% of pediatric patients on the heart transplant (HT) waiting list are supported with biventricular assist devices (BiVAD), with high waitlist mortality. There are little data on post-HT outcomes for this cohort. Methods The United Network for Organ Sharing (UNOS) database was queried for patients Results Of 4904 Pediatric HT recipients, patients were grouped by no VAD support (3934, 80.2%), LVAD only (736, 15%) and BiVAD (234, 4.8%). Overall graft survival analysis indicates crossing hazard rates between groups over time (Fig. 1a) with a significant difference of graft survival at 1 year post-HT, lowest for BiVAD (p Conclusion Pre-HT BiVAD support leads to worse graft survival 1 year post-HT compared to no VAD and LVAD patients, but is not constant over time with acceptable long-term survival. Further research is needed to investigate causes of decreased graft survival in the pediatric BiVAD population early post-HT.