Brain death interval and relationship to outcomes of pediatric cardiac transplantation

Pediatr Transplant. 2019 Jun;23(4):e13426. doi: 10.1111/petr.13426. Epub 2019 May 7.

Abstract

Background: We sought to analyze brain death interval and outcomes of pediatric cardiac transplantation using national registry data.

Methods: We retrospectively evaluated a pediatric cohort from the UNOS registry from 2005 to 2014. We restricted the donor cohort to those with a primary central nervous system event as the cause of hospitalization. Brain death interval (BDI) was defined as the time between hospital admission and organ procurement. Primary outcomes were recipient and graft survival time. Logistical regression modeling was used for multivariable analysis.

Results: The donor cohort included 2565 cases. Multivariable analysis demonstrated no relationship between BDI and recipient or graft survival time. For patient survival time, the lowest HR was 0.94 (0.63-1.39), P = 0.531; for graft survival time, the lowest HR was 0.89 (0.53-1.49), P = 0.563. We obtained similar results using a non-restricted donor cohort.

Conclusions: There was no clear relationship between BDI and recipient or graft survival after pediatric cardiac transplantation.

Keywords: brain death; cardiac transplantation; donor management; heart transplantation; pediatric cardiac transplantation; pediatric heart transplantation.

MeSH terms

  • Adolescent
  • Aorta / pathology
  • Brain Death*
  • Child
  • Child, Preschool
  • Female
  • Graft Rejection
  • Graft Survival
  • Heart Failure / mortality*
  • Heart Failure / surgery*
  • Heart Transplantation*
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Multivariate Analysis
  • Registries
  • Regression Analysis
  • Retrospective Studies
  • Tissue Donors*
  • Tissue and Organ Procurement / methods*
  • Treatment Outcome