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A longer waiting game: Bridging children to heart transplant with the Berlin Heart EXCOR device-the United Kingdom experience

Lookup NU author(s): Dr Jane Cassidy, Dr Lee Ferguson

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Abstract

BACKGROUND: Mechanical circulatory support (MCS) is used to support children with end-stage heart failure to heart transplant.METHODS: This was a retrospective cohort study of 7 years' experience with the Berlin Heart (BH) EXCOR (Berlin Heart AG, Berlin Germany) paracorporeal ventricular assist device (VAD) in 2 United Kingdom (UK) pediatric heart transplant centers and the effect of this program on the UK pediatric heart transplant service.RESULTS: Of 102 children who received BH support, 84% survived to transplant or BH explant and 81% survived to discharge. Neither age nor duration of support influenced outcome. Stroke, ongoing requirement for ventilation while on BH, and diagnosis other than dilated cardiomyopathy were the only independent mortality risk factors. Children who weighed < 20 kg had significantly (p = 0.03) longer support times than bigger children. The number of children treated with a BH increased over time (p = 0.01). Currently > 50% of pediatric heart transplants are bridged with a BH; however, pediatric transplants per year have not increased significantly (p = 0.07)CONCLUSIONS: BH use in the UK has allowed significant increases in the number of children with end-stage heart failure who can be successfully bridged to transplant and the length of time they can be supported. The total number of transplants has not increased. (C) 2013 International Society for Heart and Lung Transplantation. All rights reserved.

Publication metadata

Author(s): Cassidy J, Dominguez T, Haynes S, Burch M, Kirk R, Hoskote A, Smith J, Fenton M, Griselli M, Hsia TY, Ferguson L, Van Doorn C, Hasan A, Karimova A

Publication type: Article

Publication status: Published

Journal: Journal of Heart and Lung Transplantation

Year: 2013

Volume: 32

Issue: 11

Pages: 1101-1106

Print publication date: 01/11/2013

Online publication date: 21/09/2013

ISSN (print): 1053-2498

ISSN (electronic): 1557-3117

Publisher: Elsevier B.V.

URL: http://dx.doi.org/10.1016/j.healun.2013.08.003

DOI: 10.1016/j.healun.2013.08.003

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