Pediatric Ventricular Assist Device Use as a Bridge to Transplantation Does Not Affect Long-Term Quality of Life

Abstract

Purpose Fifteen-percent of the more than 500 children that receive a heart transplant annually require a ventricular assist device (VAD) as a bridge to transplantation. With recent data showing improved long-term survival after transplantation, it is appropriate to focus attention on whether children requiring a VAD as a bridge to transplantation fair as well as those who went straight to transplantation in terms of their long-term quality of life. Methods and Materials This study used a cross-sectional design to evaluate the long-term quality of life in children who required long-term VAD support (greater than two weeks) as a bridge to transplantation, compared to children undergoing heart transplantation without VAD support, employing the Core and Cardiac modules of the Pediatric Quality of Life Inventory (PedsQL) survey, via a telephone interview. In a secondary analysis, factors associated with worse quality of life outcome among VAD patients were also investigated. Results Among 21 children who required a ventricular assist device as a bridge to transplantation and 42 children who went straight to transplantation, there were no significant differences in quality of life as measured by their Psychosocial Health Summary Score, Physical Health Summary Score, or Total Score in the PedsQL Core module, nor were there any differences in any of the six dimensions of quality of life assessed by the PedsQL Cardiac module. Among patients who required a ventricular assist device, only the presence of a neurological complication was associated with worse quality of life, in the form of decreased Physical Health Summary and decreased Cardiac Communication scores. Conclusions Over the long-term, surviving children who required a long-term ventricular assist device as a bridge to transplantation experience a similar quality of life as those who went straight to transplantation.