“The Effect of Infectious Complications During Ventricular Assist Device Use on Outcomes of Pediatric Heart Transplantation” was published in the ASAIO Journal on July 14, 2021. This article linked 207 patients receiving a VAD followed by heart transplant between September 2012 and December 2016, using Pedimacs and Pediatric Heart Transplant Society (PHTS) data.
Group A consisted of 42 patients with 62 infectious adverse events (IAEs), while Group B was made up of 165 patients without an IAE. Group A patients were younger, waited longer for heart transplant, and were hospitalized longer post-transplant than those without an IAE.
Importantly, VAD-related IAEs were rare. Both groups were free from first post-transplant graft loss, infection, and rejection, but patients with VAD-related IAEs were somewhat more likely to experience graft loss (p = 0.01) and reflection (p = 0.03).
One note regarding the study, we were not able to control for confounders due to small numbers and outcomes associated with VAD related IAE should be interpreted with caution.
Our key takeaway? Infectious adverse events (IAEs) on VAD support did not affect post-transplant outcomes; however, VAD-related IAEs could be associated with rejection and graft loss.
Many ACTION members who contributed to this important work:
- Scott Auerbach, Children’s Hospital Colorado
- Matthew Bock, Primary Children’s Hospital
- Juan Alejos, UCLA Mattel Children’s Hospital
CITATION
Auerbach SR, Cantor RS, Bradford TT, Bock MJ, Skipper ER, Koehl DA, Butler K, Alejos JC, Edens RE, Kirklin JK. The Effect of Infectious Complications During Ventricular Assist Device Use on Outcomes of Pediatric Heart Transplantation. ASAIO J. 2021 Jul 14. doi: 10.1097/MAT.0000000000001442. Epub ahead of print. PMID: 34264872.
