Abstract:
:Extracorporeal membrane oxygenation (ECMO) has long been the sole means of mechanical support for pediatric patients with end-stage cardiac failure, but has a high waitlist mortality and a reported survival to hospital discharge of less than 50%. The purpose of this study was to compare waitlist mortality and survival for ECMO versus ventricular assist device (VAD) support. A review was conducted of all patients listed for heart transplantation (HTx) since 2002 and requiring mechanical support. VAD support has been available from 2004 (Berlin Heart Excor Pediatrics). Competing risks analysis was used to model survival to one of four outcomes (HTx, death on waitlist, delisting, improvement). Thirty-six patients were on mechanical support while awaiting HTx (21 ECMO, 12 VAD, three both). Median age at listing was 1.2 years (birth-16.6 years) for ECMO and 11.3 years (0.3-14.6 years) for VAD. Diagnosis was cardiomyopathy in 33% for ECMO and 93% for VAD. Median time to HTx was 37 days (1-930) overall, 20 days (1-85) for ECMO, and 39 days (5-108) for VAD. Mechanical support was associated with increased odds of HTx (hazard ratio [HR] 2.4 [1.7-3.3], P < 0.0001) but also delisting or death waiting (HR 3.0 [1.1-7.8], P = 0.03). Waitlist mortality of 38% on ECMO was reduced to 13% with VAD use. Survival post-HTx to hospital discharge was better in the group on VAD support (92 vs. 80%). Pediatric patients requiring mechanical support as a bridge to HTx have short wait times but high waitlist mortality. Those patients who survived to be put on the Berlin Heart Excor Pediatric device based on individualized clinical decision making then had a lower waitlist mortality, a longer duration of support, and a higher survival to transplantation and hospital discharge.
journal_name
Artif Organsjournal_title
Artificial organsauthors
Jeewa A,Manlhiot C,McCrindle BW,Van Arsdell G,Humpl T,Dipchand AIdoi
10.1111/j.1525-1594.2009.00969.xsubject
Has Abstractpub_date
2010-12-01 00:00:00pages
1087-91issue
12eissn
0160-564Xissn
1525-1594pii
AOR969journal_volume
34pub_type
杂志文章abstract::The objectives of this study were: (i) to evaluate the effects of perfusion modes (pulsatile vs. nonpulsatile) on vital organs recovery and (ii) to investigate the influences of two different perfusion modes on the homeostasis of thyroid hormones in pediatric patients undergoing cardiopulmonary bypass (CPB) procedures...
journal_title:Artificial organs
pub_type: 杂志文章,随机对照试验
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更新日期:2010-11-01 00:00:00
abstract::Transplanted allogeneic marrow grafts often fail to engraft in a lethally irradiated host. Resistance to hemopoietic allograft is a complexed phenomenon involving multiple components. To study the involvement of a hemopoietic cytokine, which was known to play a role for stem cell function, we established lines of mice...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1996.tb04563.x
更新日期:1996-08-01 00:00:00
abstract::In cardiac surgeries, it is frequently necessary to make the external blood circulation and oxygenation artificially. This procedure is called extracorporeal circulation (EC) or heart-lung bypass. During EC, one of the most important parameters, which demands continuous monitoring, is the blood flow. In many cases, th...
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pub_type: 杂志文章
doi:10.1046/j.1525-1594.2000.06532.x
更新日期:2000-03-01 00:00:00
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journal_title:Artificial organs
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doi:10.1046/j.1525-1594.2001.025002146.x
更新日期:2001-02-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1982.tb04054.x
更新日期:1982-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/aor.12908
更新日期:2017-04-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1995.tb02442.x
更新日期:1995-08-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1978.tb03442.x
更新日期:1978-05-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2003.07015.x
更新日期:2003-03-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract::From January 1980 through December 1990, implantation of a permanent pacemaker was performed in 34 patients following open heart surgery. The patients were divided into two groups according to the clinical indications for implantation of permanent pacemakers. Group 1 (9 patients) had surgical atrioventricular block, a...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1993.tb00591.x
更新日期:1993-05-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2005.29038.x
更新日期:2005-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1046/j.1525-1594.2002.07087.x
更新日期:2002-10-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2002.07029.x
更新日期:2002-10-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1994.tb03329.x
更新日期:1994-11-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2006.00261.x
更新日期:2006-07-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12144
更新日期:2013-09-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12196
更新日期:2014-05-01 00:00:00
abstract::Implantable ventricular assist devices have proven efficacious as a bridge to transplantation and as a bridge to recovery. Although current indications for use of assist devices are somewhat limited, they are likely to expand in the upcoming years, including their use as destination therapy for end-stage heart failure...
journal_title:Artificial organs
pub_type: 杂志文章,评审
doi:10.1046/j.1525-1594.2002.07122.x
更新日期:2002-11-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1978.tb03465.x
更新日期:1978-08-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
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更新日期:1978-11-01 00:00:00
abstract::Biomechanical actuation of an implanted ventricular assist device (VAD) is an attractive means of providing long-term circulatory support. Studies show that energy from electrically stimulated skeletal muscle can, in principle, be used to provide tether-free cardiac assistance without the need for percutaneous driveli...
journal_title:Artificial organs
pub_type: 杂志文章
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更新日期:2011-07-01 00:00:00
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更新日期:2014-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2009-10-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
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更新日期:2007-12-01 00:00:00
abstract::We designed a 24-field array and an on-line control box that selects which and how many of 24 fields will conduct electrical charge during functional electrical stimulation. The array was made using a conductive microfiber textile, silver two-component adhesive, and the conductive ink imprint on the polycarbonate. The...
journal_title:Artificial organs
pub_type: 杂志文章
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更新日期:2005-06-01 00:00:00
abstract::Filtration through membranes with different nominal cut-off was used for isolation of middle molecule fractions from uremic serum. Comparison was made with test substances which in gel filtration did not show a regular relationship between molecular weight and partition coefficient. The XM50 membrane (cut-off 50,000 D...
journal_title:Artificial organs
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::The presence in rat serum of three novel immunosuppressive proteins is associated with induction of tolerance after liver grafting. One of these, KX-5 (40 kilodalton molecular weight) is present 40-100 days after grafting of DA liver into PVG, a combination in which liver grafts are not rejected; two others, KX-2 (87 ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1996.tb00646.x
更新日期:1996-10-01 00:00:00
abstract::The cochlea is an end organ, which is metabolically dependent on a nutrient and oxygen supply to maintain its normal physiological function. Cochlear ischemia and reperfusion (IR) injury is considered one of the most important causes of human idiopathic sudden sensorineural hearing loss. The aim of the present study w...
journal_title:Artificial organs
pub_type: 杂志文章
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更新日期:2017-08-01 00:00:00
abstract::Centrifugal blood pumps are considered to be generally superior to the traditionally used roller pumps in cardiopulmonary bypass. In our institute a new lightweight centrifugal sealless blood pump with a unique spherical thrust bearing and with a magnetic coupling was developed, the HiFlow. The small design makes the ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1997.tb03754.x
更新日期:1997-07-01 00:00:00