Abstract：
BACKGROUND:Although some prior studies have provided evidence to question the historical belief that pulmonary vascular resistance index ⩾6 Wood Units×m2 should be a contraindication to heart transplantation in children, no national analyses specific to the modern area have addressed this question. METHODS:Data were analysed for paediatric heart transplant recipients from 1 January, 2002 to 1 September, 2012 (n=699). The relationship between pulmonary vascular resistance and all-cause 30-day mortality was evaluated using univariate and multivariate analyses. RESULTS:The 30-day mortality included 10 patients (1.43%), which is lower than in the previous analyses. Receiver operating curve analysis of pulmonary vascular resistance index as a predictor of mortality yielded a cut-off value of 3.37 Wood Units×m2, but the area under the curve and specificity of this threshold was weaker than in previous analyses. Whereas pulmonary vascular resistance index treated as a dichotomised variable was a significant predictor of mortality in univariate (odds ratio 4.92, 95% confidence interval 1.04-23.33, p=0.045) and multivariate (odds ratio 5.26, 95% confidence interval 1.07-25.80, p=0.041) analyses, pulmonary vascular resistance index treated as a continuous variable was not a significant predictor of mortality in univariate (p=0.12) or multivariate (p=0.11) analyses. CONCLUSIONS:The relationship between pulmonary vascular resistance and post-heart transplant mortality in children is less convincing in this analysis of a comprehensive, contemporary database than in previous series. This suggests the possibility that modern improvements in the management of post-transplant right ventricular dysfunction have mitigated the contribution of pulmonary hypertension to early mortality.
journal_name
Cardiol Youngjournal_title
Cardiology in the youngauthors
Maxwell BG,Sheikh AY,Ajuba-Iwuji CC,Heitmiller ES,Vricella LAdoi
10.1017/S1047951114001796subject
Has Abstractpub_date
2015-08-01 00:00:00pages
1141-7issue
6eissn
1047-9511issn
1467-1107pii
S1047951114001796journal_volume
25pub_type
杂志文章abstract：BACKGROUND:In very low birth weight infants, persistence of a patent ductus arteriosus results in morbidity and mortality. Therapies to close the ductus are effective, but clinical outcomes may depend on the accuracy of diagnosis and the timing of administration. The objective of the present study was to characterise t...
journal_title：Cardiology in the young
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journal_title：Cardiology in the young
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journal_title：Cardiology in the young
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journal_title：Cardiology in the young
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journal_title：Cardiology in the young
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journal_title：Cardiology in the young
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pub_type： 杂志文章,多中心研究
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