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Hypoalbuminemia and poor growth predict worse outcomes in pediatric heart transplant recipients
Author(s) -
Castleberry Chesney,
WhiteWilliams Connie,
Naftel David,
Tresler Margaret A.,
Pruitt Elizabeth,
Miyamoto Shelley D.,
Murphy Debbie,
Spicer Robert,
Bannister Louise,
Schowengerdt Kenneth,
Gilmore Lisa,
Kaufman Beth,
Zangwill Steven
Publication year - 2014
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12239
Subject(s) - medicine , hypoalbuminemia , multivariate analysis , risk factor , heart transplantation , transplantation , heart disease , risk of mortality , pediatrics , intensive care medicine
Children with end‐stage cardiac failure are at risk of HA and PG . The effects of these factors on post‐transplant outcome are not well defined. Using the PHTS database, albumin and growth data from pediatric heart transplant patients from 12/1999 to 12/2009 were analyzed for effect on mortality. Covariables were examined to determine whether HA and PG were risk factors for mortality at listing and transplant. HA patients had higher waitlist mortality (15.81% vs. 10.59%, p = 0.015) with an OR of 1.59 (95% CI 1.09–2.30). Survival was worse for patients with HA at listing and transplant (p ≤ 0.01 and p = 0.026). Infants and patients with congenital heart disease did worse if they were HA at time of transplant (p = 0.020 and p = 0.028). Growth was poor while waiting with PG as risk factor for mortality in multivariate analysis (p = 0.008). HA and PG are risk factors for mortality. Survival was worse in infants and patients with congenital heart disease. PG was a risk factor for mortality in multivariate analysis. These results suggest that an opportunity may exist to improve outcomes for these patients by employing strategies to mitigate these risk factors.