Abstract:
:Avoidance of red blood cell (RBC) transfusions in patients awaiting heart transplantation (HTx) has been suggested to minimize the risk of allosensitization. Although recent studies have suggested that an immature immune system in younger HTx recipients may reduce risks associated with RBC transfusion, the role of age in moderating the influence of transfusion on HTx outcomes remains unclear. We used available data from a national transplant registry to explore whether the association between pre-transplant transfusions and outcomes of pediatric HTx varies by patient age. De-identified data were obtained from the United Network for Organ Sharing registry, including first-time recipients of isolated HTx performed at age 0-17 years in 1995-2015. The primary exposure was receiving blood transfusions within 2 weeks prior to HTx. Patient survival after HTx was evaluated using multivariable Cox proportional hazards, where age at transplant was interacted with exposure to pre-transplant transfusion. Age-specific hazard ratios (HRs) of pre-transplant transfusion were plotted across ages at transplant. There were 4883 patients meeting inclusion criteria, of whom 1258 died during follow-up (mean follow-up duration 6 ± 5 years). Patients receiving pre-transplant transfusions were distinguished by younger age, higher prevalence of prior cardiac surgery, greater likelihood of being in the intensive care unit, and greater use of left ventricular assist device bridge to transplant. In multivariable analysis, pre-transplant transfusions were associated with increased mortality hazard among infants < 1 year of age (HR = 1.46; 95% CI 1.23, 1.74; p < 0.001). For each additional year of age, the excess hazard associated with pre-transplant transfusions decreased by 3% (interaction HR = 0.97; 95% CI 0.98, 0.99; p = 0.003). By age 8, the association between pre-transplant transfusions and post-transplant mortality was no longer statistically significant (HR = 1.15; 95% CI 0.99, 1.32; p = 0.060). Pre-transplant transfusions were associated with increased mortality hazard only among younger children (age < 8 years) undergoing HTx. These data support the current practices of transfusion avoidance prior to HTx, particularly in younger patients.
journal_name
Pediatr Cardioljournal_title
Pediatric cardiologyauthors
McKee C,Tumin D,Alevriadou BR,Nicol KK,Yates AR,Hayes D Jr,Tobias JDdoi
10.1007/s00246-018-1814-ysubject
Has Abstractpub_date
2018-04-01 00:00:00pages
743-748issue
4eissn
0172-0643issn
1432-1971pii
10.1007/s00246-018-1814-yjournal_volume
39pub_type
杂志文章abstract::Pulmonary arterial hypertension (PAH) is a major cause of morbidity and mortality among patients with congenital heart disease (CHD). This study was designed to determine biomarker levels in patients with PAH associated with CHD (PAH-CHD) and CHD patients without PAH and to investigate the relationship of these potent...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0321-9
更新日期:2012-12-01 00:00:00
abstract::This report describes the case of two pediatric patients who demonstrated echocardiographic evidence of pulmonary hypertension (PH) during the acute phase of Kawasaki disease. The etiology of PH development in this setting is currently unknown, but the authors hypothesize that pulmonary vasculitis may play a significa...
journal_title:Pediatric cardiology
pub_type: 杂志文章,评审
doi:10.1007/s00246-012-0510-6
更新日期:2013-01-01 00:00:00
abstract::A case report of a neonate with cardiac tumors in association with tuberous sclerosis is presented. The rare complication of pulmonary embolism and its successful treatment by anticoagulation and thrombolytic therapy is described. The treatment of these cardiac tumors is conservative, because the tumors regress sponta...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s002460010247
更新日期:2001-07-01 00:00:00
abstract::It is shown that phosphodiesterase type 5 (PDE5) inhibitors such as sildenafil can modulate pulmonary arterial hypertension (PAH) via increasing the level of guanosine-3,5-cyclic monophosphate (cGMP) and decreases pulmonary artery pressure (PAP). In this study we determined the effectiveness of sildenafil and compared...
journal_title:Pediatric cardiology
pub_type: 临床试验,杂志文章
doi:10.1007/s00246-007-9139-2
更新日期:2008-05-01 00:00:00
abstract::Debilitating cardiomyocyte loss underlies the progression to heart failure. Although there have been significant advances in treatment, current therapies are intended to improve or preserve heart function rather than regenerate lost myocardium. A major hurdle in implementing a cell-based regenerative therapy is the in...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-009-9409-2
更新日期:2009-07-01 00:00:00
abstract::We analyzed early and late results of surgical treatment of 100 consecutive children with Down's syndrome (DS) and congenital heart defect (CHD) who were operated on between 1990 and 1997. Fifty had common atrioventricular canal (CAVC), 24 ventricular septal defect, 8 the ostium primum atrial septal defect, 8 tetralog...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s002469900483
更新日期:1999-09-01 00:00:00
abstract::We present a neonatal case with intractable atrial flutter that did not respond to digitalization and electrical cardioversion. Intravenous flecainide administration completely resolved the atrial flutter. Proarrhythmic effects were not induced by flecainide administration. Although the efficacy of flecainide for atri...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-003-0226-8
更新日期:2004-03-01 00:00:00
abstract::Arrhythmias in pregnancy are becoming more common given more available and effective medical, ablation and device treatment options. Several changes associated with pregnancy, increased blood volume, cardiac output, and heart rate secondary to an increased sympathetic state, facilitate more frequent occurrences of arr...
journal_title:Pediatric cardiology
pub_type: 杂志文章,评审
doi:10.1007/s00246-015-1232-3
更新日期:2015-10-01 00:00:00
abstract::The purpose of the study was to evaluate school-age developmental and educational outcomes for children with and without a cardiac procedure in the first year of life to improve understanding of longer-term neurodevelopmental outcomes in children who have had a cardiac procedure for congenital heart disease, the most ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-018-2029-y
更新日期:2019-03-01 00:00:00
abstract::Serum troponin (Tn) is often elevated in viral myocarditis; however, its prognostic significance is unknown. We tested the hypothesis that abnormal serum Tn is associated with mortality in children hospitalized with myocarditis. We retrospectively studied data from six large children's hospitals participating in the P...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-018-1871-2
更新日期:2018-08-01 00:00:00
abstract::Ejection fraction (EF) and fractional shortening (FS) are standard methods of quantifying left ventricular (LV) systolic function. 2D global longitudinal strain (2D GLS) is a well-established, but underutilized method for LV function quantification. The aim of this study was to assess precision of GLS compared to EF &...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-019-02243-8
更新日期:2020-01-01 00:00:00
abstract::Left ventricular hypertrophy is an adaptive mechanism in children undergoing chronic dialysis to improve contractility at rest. The aim of this study was to determine the left ventricular performance and contractility reserve by "dobutamine stress echocardiography" in children undergoing chronic dialysis. Thirty-five ...
journal_title:Pediatric cardiology
pub_type: 临床试验,杂志文章
doi:10.1007/s00246-010-9721-x
更新日期:2010-10-01 00:00:00
abstract::The effect of patent ductus arteriosus (PDA) treatment with cyclooxygenase (COX) inhibitors (indomethacin [INDO] and ibuprofen [IBU]) on regional oxygenation requires further clarification. The authors hypothesized that both INDO and IBU reduce regional tissue oxygenation in preterm neonates with PDA but that the risk...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0309-5
更新日期:2012-12-01 00:00:00
abstract::Beta-blocker therapy is one of the principal therapies for congenital long-QT syndrome (LQTS). However, breakthrough cardiac events occur while being treated with beta-blockers. We sought to determine the frequency of and clinical correlates underlying beta-blocker therapy failures in genotyped, symptomatic LQTS proba...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-003-0567-3
更新日期:2004-09-01 00:00:00
abstract::With the advent of cardiac magnetic resonance imaging and high-resolution echocardiography, cardiac catheterization is unnecessary in clinical protocols in the "routine" single ventricle patient. Catheterization adds little to clinical care in these cases, and there are significant risks and costs associated with it. ...
journal_title:Pediatric cardiology
pub_type: 杂志文章,评审
doi:10.1007/s00246-004-0960-6
更新日期:2005-03-01 00:00:00
abstract::Adult studies suggest a better functional outcome after aortic valve replacement with a pulmonary autograft compared with mechanical or homograft valves. Little is known about functional results after Ross surgery in growing children. This study reports formal exercise stress echocardiographic data from 26 pediatric R...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0218-7
更新日期:2012-06-01 00:00:00
abstract::We report the case of a fetus diagnosed at 24 weeks' gestation with complete heart block associated with maternal collagen vascular disease and Sjögren's antibody. Serial fetal echocardiograms noted increased echogenicity along the tricuspid and mitral valves without insufficiency. Postnatally, severe tricuspid insuff...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF00800677
更新日期:1994-07-01 00:00:00
abstract::The slip ring and nutate/rotate configuration of the new, fourth-generation, computed tomography (CT) (TCT-900S, Toshiba Medical Company) makes it possible to scan consecutively 25 slices every 75 s. This scanner also rapidly provides hemodynamic and multiplanar reconstruction images. Studies were performed on 13 chil...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF02309917
更新日期:1989-04-01 00:00:00
abstract::Maintaining patency of the ductus arteriosus pending surgical intervention can be critical to the survival of the neonate with ductal dependent congenital heart disease. Spontaneously delayed ductal closure has been observed clinically and experimentally in newborns with critical pulmonic stenosis. Infants with ductal...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF02263445
更新日期:1987-01-01 00:00:00
abstract::The relationship between pulmonary function and right ventricle (RV) in Duchenne muscular dystrophy (DMD) has not been evaluated. Using cardiac magnetic resonance (CMR), we describe the relationship of RV size and function with spirometry in a DMD cohort. Fifty-seven boys undergoing CMR and pulmonary function testing ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-016-1362-2
更新日期:2016-06-01 00:00:00
abstract::Right ventricular (RV) remodeling in hypoplastic left heart syndrome (HLHS) begins prenatally and continues through staged palliations. However, it is unclear if the most marked observed remodeling post-Norwood is secondary to cardiopulmonary bypass (CPB) exposure or if it is an adaptation intrinsic to the systemic RV...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-020-02482-0
更新日期:2020-10-10 00:00:00
abstract::To reveal the association between DNMT1 polymorphisms and congenital heart disease (CHD) in child patients, a total of 224 CHD child patients as well as 199 healthy individuals were enrolled in the present study. The DNA was extracted from whole blood, and four SNPs including rs16999593, rs2228612, rs2288349 and rs104...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-015-1093-9
更新日期:2015-06-01 00:00:00
abstract::Marfan syndrome (MS) is a connective tissue disease involving the cardiovascular, ocular, and the musculoskeletal systems. MS has variable phenotypic expression and is most often diagnosed in adult life. Infantile-onset MS is rare and is associated with severe cardiovascular manifestations; there is an extremely high ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-006-0066-4
更新日期:2007-09-01 00:00:00
abstract::The outcome in a series of 23 cases of tetralogy of Fallot diagnosed prenatally was compared to published figures for this condition when (a) identified postnatally or (b) treated surgically. There was a marked difference in the survival between these groups, with the highest mortality (75%) occurring when the diagnos...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF00788220
更新日期:1992-01-01 00:00:00
abstract::Aortopulmonary window coexisting with tetralogy of Fallot (TF) was prospectively diagnosed by two-dimensional (2D) echocardiography and Doppler in an 18-month-old boy; the diagnosis was confirmed by cardiac catheterization and angiocardiography. Surgical correction was performed, but the patient died in the operating ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF02239546
更新日期:1990-01-01 00:00:00
abstract::We studied the safety and efficacy of closing patent ductus arteriosus by Nit-Occlud coils via retrograde approach. This is a retrospective study of 46 attempts to close ducts by this method in two hospitals in Egypt and Iran. Ductus arteriosus was crossed by left or right Judkins or endhole catheters. The coil was de...
journal_title:Pediatric cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00246-017-1589-6
更新日期:2017-04-01 00:00:00
abstract::This case discusses a Shone's variant with small left ventricle and mitral valve, bicuspid aortic valve, coarctation of the aorta, an unusual arrangement of atrial appendages, and partially anomalous pulmonary venous drainage due to a deviated atrial septum. The left atrial appendage could be directly entered from the...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-006-1364-6
更新日期:2006-09-01 00:00:00
abstract::This report describes an unusual case with tortuosity of the great vessels in a neonate who presented at birth with cyanosis. The diagnosis was made with magnetic resonance imaging (MRI), then confirmed by genetic analysis. ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-009-9486-2
更新日期:2009-11-01 00:00:00
abstract::Congenital heart defect (CHD) represents the most prevalent birth defect, and accounts for substantial morbidity and mortality in humans. Aggregating evidence demonstrates the genetic basis for CHD. However, CHD is a heterogeneous disease, and the genetic determinants underlying CHD in most patients remain unknown. In...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-018-1822-y
更新日期:2018-04-01 00:00:00
abstract::We retrospectively investigated the effect of warfarin therapy in improving the clinical outcome of Kawasaki disease (KD) patients with giant coronary aneurysms (GAs). We followed 2350 KD patients from 1973 to 2004. The GAs (> or =8 mm in diameter) were diagnosed by coronary angiography. Sixty-eight patients (54 males...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-007-9132-9
更新日期:2008-03-01 00:00:00