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Variation in the use of surveillance endomyocardial biopsy among pediatric heart transplant centers over time
Author(s) -
Godown Justin,
Harris Michelle T.,
Burger Judith,
Dodd Debra A.
Publication year - 2015
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.12518
Subject(s) - medicine , endomyocardial biopsy , heart transplantation , pediatrics , emergency medicine , biopsy , surgery , transplantation
EMB is widely utilized for graft surveillance after HT x; however, there is significant variation in the frequency of surveillance EMB use during the first year post‐ HT x. The aim of this study was to assess changes in the utilization of surveillance EMB over time among member institutions of PHTS . A survey of PHTS centers assessing the frequency of surveillance EMB use during the first year post‐ HT x was conducted in 2006. The same survey was repeated in 2014 to assess changes in practice over time. The number of EMB in infants ranged from 0 to 9 and in adolescents 0 to 16. The number of EMB decreased or remained unchanged in the majority of centers. Fewer EMB are performed in infants compared to adolescents and this practice did not change over time. There was a significant decrease in surveillance EMB use in adolescents (p = 0.012). International centers perform significantly fewer EMB in adolescents when compared to centers within the United States (p = 0.006). There continues to be significant variation in the utilization of surveillance EMB , with a shift toward less reliance on EMB for adolescents in the current era. Further research is necessary to determine the optimal frequency of invasive monitoring that reduces costs without compromising outcomes.