Heart transplant

Pediatric heart transplant wait times have increased during the pandemic, but mortality has not

October 07, 2022

1 minute read


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During the COVID-19 pandemic, wait times for pediatric heart transplants were longer than before the pandemic, but waitlist mortality did not change, according to a research letter published in Open JAMA Network.

The researchers compared 610 children (mean age, 6.93 years) who received a heart transplant during the pandemic period, defined as March 2020 to June 2021, with 626 children (mean age, 6.74 years) who received a heart transplant during the pre-pandemic period period defined from November 2018 to February 2020.

Graphical representation of the data presented in the article

Data are from Iguidbashian J, et al. JAMA Netw Open. 2022;doi:10.1001/jamanetworkopen.2022.34874.

Most recipient and donor characteristics were similar between the groups, but recipients during the pandemic period were less likely to have ventilatory support before transplant than those during the pre-pandemic period (7% versus 12%; P = .01), John Iguidbashian, MD, a general surgery resident at the University of Colorado School of Medicine, and his colleagues wrote.

The average length of the waiting list was 157.4 days during the pandemic versus 126 days before the pandemic (mean difference, 32 days; 95% CI, 0.3-63; P = 0.05), the researchers wrote.

Waitlist survival, post-transplant survival and graft survival were all comparable between the pandemic and pre-pandemic period, Iguidbashian and colleagues found.

The mean postoperative length of stay was shorter in the pandemic group than in the pre-pandemic group (31 days versus 40 days; mean difference, -9 days; 95% CI, -15 to -4; P = .001), according to the researchers.

“These findings are testament to multidisciplinary initiatives to maintain care delivery among this vulnerable patient population, as children with end-stage heart failure have high rates of wait-list mortality due to limited availability donor organs,” Iguidbashian and colleagues wrote. “Although our findings suggest that heart transplant outcomes have been sustained during the pandemic, continued diligence is warranted. The survival and quality of life of children awaiting heart transplantation will depend on a collaborative commitment to standardized decision-making and critical outcome analysis.