Measuring Quality in Pediatric Heart Transplantation-An Important but Challenging Goal.

Published on Nov 2, 2020
· DOI :10.1001/JAMANETWORKOPEN.2020.24137
Kimberly Y. Lin14
Estimated H-index: 14
(UPenn: University of Pennsylvania),
Joseph W. Rossano44
Estimated H-index: 44
(UPenn: University of Pennsylvania)
#1Tajinder P. Singh (Harvard University)H-Index: 28
#2Mandeep R. Mehra (Harvard University)H-Index: 90
Last. Kimberlee Gauvreau (Harvard University)H-Index: 85
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Importance Differences among pediatric transplant centers in long-term survival of pediatric recipients of heart transplants can be mostly explained by differences in 90-day mortality. Objective To understand characteristics associated with high-performing pediatric HT centers by comparing key outcomes among centers stratified by 90-day risk-adjusted mortality. Design, Setting, and Participants This retrospective cohort study included recipients of HT aged younger than 18 years in the US. Analys...
#1Tajinder P. Singh (Harvard University)H-Index: 28
#2Kimberlee Gauvreau (Harvard University)H-Index: 85
: The official analysis of posttransplant survival considers only recently transplanted patients and suggests absence of outcome differences among pediatric heart transplant (HT) centers. We sought to compare posttransplant survival among currently active pediatric HT centers in the United States over 15 years of activity. We identified all children <18 years old who underwent their first HT during 2000-2014 at US centers active during 2013-14. Recipients were followed until March 2016. A mixed-...
#3Joseph W. Rossano (Children's Hospital of Philadelphia)H-Index: 44
Background Risk assessment in heart transplantation is critical for candidate selection, but current models inadequately assess individual risk of postoperative mortality. We sought to identify risk factors and develop a scoring system to predict mortality after heart transplantation in children. Methods The records of patients undergoing heart transplantation at our institution from 2010 through 2016 were reviewed. Clinical characteristics were recorded and compared between survivors and nonsur...
#1Christopher S. Almond (Harvard University)H-Index: 35
#2Kimberlee Gauvreau (Harvard University)H-Index: 85
Last. Tajinder P. Singh (Harvard University)H-Index: 28
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We sought to develop and validate a quantitative risk-prediction model for predicting the risk of posttransplant in-hospital mortality in pediatric heart transplantation (HT). Children <18 years of age who underwent primary HT in the United States during 1999–2008 (n = 2707) were identified using Organ Procurement and Transplant Network data. A risk-prediction model was developed using two-thirds of the cohort (random sample), internally validated in the remaining one-third, and independently va...
#1Melanie D. Everitt (Primary Children's Hospital)H-Index: 26
#2Gerard J. Boyle (Cleveland Clinic)H-Index: 21
Last. Charles E. Canter (WashU: Washington University in St. Louis)H-Index: 66
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Background Infant heart transplant (HT) recipients have the best long-term survival of any age group, but the small donor pool and high early mortality limit the therapeutic effectiveness. We sought to determine the relationship between pre-HT diagnosis and early HT outcome to better define the mortality risk associated with a diagnosis of congenital heart disease (CHD) and to examine differences between early and current HT eras. Methods The Pediatric Heart Transplant Study (PHTS) database was ...
#1Jacqueline M. Lamour (Columbia University)H-Index: 24
#2Kirk R. Kanter (Emory University)H-Index: 57
Last. CtrdH-Index: 1
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Objectives We sought to evaluate the outcomes and identify risk factors for mortality after heart transplantation (HT) for congenital heart disease (CHD) in infants, children, and adults. Background CHD is considered a risk factor for mortality after HT, yet this unique group of patients represents a spectrum of complexity. Methods There were 488 patients transplanted for CHD from the combined Pediatric Heart Transplant Study (1993 to 2002, n = 367) and the Cardiac Transplant Registry Database (...
#1Adrian Kantrowitz (SUNY Downstate Medical Center)H-Index: 10
#2Jordan D. Haller (SUNY Downstate Medical Center)H-Index: 3
Last. Hans E. Carstensen (SUNY Downstate Medical Center)H-Index: 2
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Abstract Experience with human heart transplantation is reported. A technically successful infant heart transplantation was performed on December 6, 1967. The child died 612 hours postoperatively in severe metabolic and respiratory acidosis. Another heart transplantation was performed on January 5, 1968; the recipient was a 57-year old man. The donor heart was unable to support the circulation, and the patient died 1012 hours postoperatively. Problems in the selection of donors and of recipients...
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