Table 1.
Patient demographics, primary diagnosis, and comorbidities (n=30)
| Variable | n (%), median [IQR] |
|---|---|
| Patient Demographics | |
| Age at transplant, years | 9 [6–12] |
| Female gender, n (%) | 19 (63.3) |
| Male gender, n (%) | 11 (36.6) |
| Weight at transplant, kg | 25.6 [22.3–35.0] |
| Primary Diagnosis | |
| DCM and related cases | |
| - DCM, n (%) | 20 (66.7) |
| CHD and complex defects | |
| - Complex CHD, n (%) | 5 (16.7) |
| Other cardiac conditions | |
| - Complete Heart Block on PPM Post Arrest, n (%) | 1 (3.3) |
| - Kawasaki Disease with Coronary Abnormalities, n (%) | 1 (3.3) |
| VLCAD deficiency, n (%) | 1 (3.3) |
| Familial hypercholesterolemia, n (%) | 2 (6.6) |
Table 2.
Pre-transplant status and clinical parameters
| Variable | n (%), median [IQR] |
|---|---|
| Duration of heart failure, months | 04 [2–15] |
| Decompensation status | |
| - Mechanical support, n (%) | 29 (96.7) |
| - Inotropic support, n (%) | 01 (3.3) |
| Mechanical support type | |
| - ECMO, n (%) | 11 (36.6) |
| - HeartMate 3, n (%) | 08 (26.4) |
| - Berlin Heart EXCOR, n (%) | (33.3) |
| - Inotropic support only, n (%) | 01 (3.3) |
| Duration of mechanical support before transplant, days | 26 [6–92] |
| Pre-transplant ventilation, n (%) | 17 (56.7) |
| Duration of ventilation, days | 08 [2–15] |
Table 3.
Intraoperative data and complications.
| Variable | n (%), median [IQR] |
|---|---|
| Donor age, years | 28 [13–36] |
| Donor gender | |
| - Male, n (%) | 17 (56.7) |
| - Female, n (%) | 13 (43.3) |
| Ischemic time, minutes | 260 [202–299] |
| Intraoperative complications | |
| - Bleeding, n (%) | 17 (56.7) |
| - Bleeding + Hypotension, n (%) | 12 (40.0) |
| - RV low contractility + Hypotension, n (%) | 1 (3.3) |
| ACC time, minutes | 185 [102–218] |
| CPB time, minutes | 231 [206–301] |
Table 4.
Early post-transplant outcomes (30 days)
| Variable | n (%), median [IQR] |
|---|---|
| 30-day survival, n (%) | 28 (93.5) |
| Acute graft rejection, n (%) | 3 (9) |
| Rejection | |
| - Cellular rejection, steroids/Tac optimization, n (%) | 1 (3.3) |
| - Cellular/Humoral rejection, unspecified, n (%) | 1 (3.3) |
| - Humoral rejection, IVIGb/plasmapheresis n (%) | 1 (3.3) |
| Infections within 30 days, n (%) | 4 (13.3) |
| Acute kidney injury, n (%) | 8 (26.7) |
| CRRT, n (%) | 2 (6.7) |
| Liver dysfunction, n (%) | 6 (19.8) |
| Neurological complications, n (%) | 3 (10.3) |
| Post-op ventilation duration, days | 8 [2–15] |
| ICU LOS, days | 20 [11–33] |
| Hospital LOS, days | 37 [22–66] |
Table 5.
comparative analysis of the heart transplant after ECMO or VAD support.
| Variable | ECMO (n = 11) | VAD (n = 18) |
|---|---|---|
| 30-day survival | 10/11 (91%) | 17/18 (94%) |
| Acute rejection | 1 (9%) | 2 (11%) |
| Infections | 2 (18%) | 2 (11%) |
| Acute kidney injury (AKI) | 4 (36%) | 4 (22%) |
| CRRT required | 1 (9%) | 1 (6%) |
| Neurological complications | 2 (18%) | 1 (6%) |
| Liver dysfunction | 2 (18%) | 4 (22%) |
| Post-op ventilation (days) | 12 [9–16] | 6 [5–9] |
| ICU LOS (days) | 24 [18–34] | 16 [10–24] |
| Hospital LOS (days) | 42 [28–66] | 34 [22–50] |
Figure 1.
ICU length of stay (LOS) stratified by pre-transplant support type. Boxplot comparing ICU LOS in patients bridged with extracorporeal membrane oxygenation (ECMO, n = 11) versus ventricular assist devices (VAD: HeartMate 3 and Berlin Heart EXCOR, n = 18). Median ICU LOS was longer in ECMO patients (12 days, IQR 9–16) compared to VAD patients (6 days, IQR 5–9), p = 0.04 (Wilcoxon rank-sum test). Boxes represent the interquartile range, whiskers the range, and horizontal lines the median.
Fig. 2.
Kaplan–Meier 30-day survival after pediatric heart transplantation (n = 30). Kaplan–Meier survival curve demonstrates 30-day survival of 28/30 patients (93.5%, 95% CI 78–99). Two deaths occurred on days 10 and 18. Survival probability remained stable after day 18. Due to only two events, regression analysis was not performed.