Post-Transplant Outcomes in Pediatric Patients Receiving Mechanical Circulatory Support: A Multicenter Study from the International Society for Heart and Lung Transplantation (ISHLT) Registry

Abstract

Purpose While extracorporeal membrane oxygenation (ECMO) was previously the most common type of mechanical circulatory support (MCS) as a bridge to transplant in pediatric heart transplant recipients, the use of ventricular assist devices (VADs) has grown dramatically. The difference in risk profile between VADs and ECMO in patients bridged to transplant is documented, yet there are limited data on the effect of type of MCS on post-transplant outcome. We compare outcomes in pediatric patients bridged to transplant with MCS from an international cohort. Methods The 1998-2017 ISHLT registry data was used to identify patients Results 7050 patients were included with 28.4% Conclusion Patients on ECMO prior to transplant are younger, with more complex anatomy than those supported with VADs. Adjusting for pre-transplant characteristics, ECMO has an increased risk of death compared with VAD, suggesting investigation into VAD support for younger patients and those with CHD may have important clinical implications.