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Fifty-Year Pediatric Heart Transplant Outcomes: A Pediatric-Adult Center Linked Analysis.

Fifty-Year Pediatric Heart Transplant Outcomes: A Pediatric-Adult Center Linked Analysis. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Hollander, S. A., Hsiao, S., Varshney, A. S., Luikart, H., Raissadati, A., Bernstein, D., Ma, M., Wujcik, K., Barkoff, L., Dykes, J., Lee, D., Rosenthal, D. N. 2025

Abstract

Long-term outcomes after pediatric heart transplant (pHT) are rarely reported owing to young programs and loss of follow-up after transition to adult care. We leveraged our program age, center volume, and linked electronic medical record (EMR) to analyze 50-year outcomes after pHT, including events after adult care transfer.Retrospective review of all pHT over 50 years at Stanford (8/19/1974-8/19/2024). Patient characteristics and post-transplant outcomes, including death, retransplant, and subsequent kidney transplantation, were ascertained from the pediatric and adult EMRs, public records, and personal communication with other centers.There were 567 pHTs in 540 patients. Status as of 8/19/2024 was confirmed for 526 (97%),11 (2%) had partial follow-up, and 3 were missing. Over 1,888,341 follow-up days, 50 (9%) received a 2nd heart transplant (HT) (27 pediatric, 23 adult) after a median of 9 (5, 14) years; 3 (1%) received a 3rd HT; 6 (1%) received a subsequent kidney transplant, and 212 (39%) died (172 pediatric, 40 adult). Median survival was 16.7 years; survival improved in successive eras (P<0.001).This linked analysis of pediatric and adult programs shows excellent long-term pHT outcomes with median survival exceeding 15 years and improving. Nearly half of retransplants occur after transfer; subsequent kidney transplant occurs infrequently.

View details for DOI 10.1016/j.healun.2025.10.022

View details for PubMedID 41297732