Heart Transplantation in Children With Down Syndrome

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Kenneth Knecht¹  Sherry Pye¹  Danielle Burstein²  Shawn West³  Neha Bansal⁴  Chet Villa⁵  Marc Richmond⁶  Zdenka Reinhardt⁷  Gary Beasley⁸  Kae Watanabe⁹  Darlene Fountain^1,10  Justin Godown^1,10  Kimberly Molina^1,11  Seth A. Hollander^1,12  Joseph A. Spinner^1,13  Simon Urschel^1,14  Rebecca Ameduri^1,15  Susan Anderson^1,15  Janet Scheel^1,16 

[1] Division of Pediatric Cardiology Arkansas Children's HospitalLittle Rock AR;Division of Pediatric Cardiology Children's Hospital of PhiladelphiaPhiladelphia PA;Division of Pediatric Cardiology Children's Hospital of PittsburghPittsburgh PA;Division of Pediatric Cardiology Children’s Hospital at MontefioreBronx NY;Division of Pediatric Cardiology Cincinnati Children's Hospital Medical Center Cincinnati OH;Division of Pediatric Cardiology Columbia University Medical Center New York NY;Division of Pediatric Cardiology Freeman Hospital The Newcastle upon TyneUnited Kingdom;Division of Pediatric Cardiology LeBonheur Children's HospitalMemphis TN;Division of Pediatric Cardiology Lurie Children's HospitalChicago IL;Division of Pediatric Cardiology Monroe Carell Jr. Children’s Hospital at VanderbiltNashville TN;Division of Pediatric Cardiology Primary Children's HospitalSalt Lake City UT;Division of Pediatric Cardiology Stanford University Palo Alto CA;Division of Pediatric Cardiology Texas Children's HospitalHouston TX;Division of Pediatric Cardiology University of Alberta Edmonton AB Canada;Division of Pediatric Cardiology University of Minnesota Minneapolis MN;Division of Pediatric Cardiology Washington University St. Louis MO;

关键词: Down syndrome;    health disparities;    heart transplantation;    outcomes;   

DOI  :  10.1161/JAHA.121.024883

来源: DOAJ

【 摘 要 】

Background Children with Down syndrome (DS) have a high risk of cardiac disease that may prompt consideration for heart transplantation (HTx). However, transplantation in patients with DS is rarely reported. This project aimed to collect and describe waitlist and post– HTx outcomes in children with DS. Methods and Results This is a retrospective case series of children with DS listed for HTx. Pediatric HTx centers were identified by their participation in 2 international registries with centers reporting HTx in a patient with DS providing detailed demographic, medical, surgical, and posttransplant outcome data for analysis. A total of 26 patients with DS were listed for HTx from 1992 to 2020 (median age, 8.5 years; 46% male). High‐risk or failed repair of congenital heart disease was the most common indication for transplant (N=18, 69%). A total of 23 (88%) patients survived to transplant. All transplanted patients survived to hospital discharge with a median posttransplant length of stay of 22 days. At a median posttransplant follow‐up of 2.8 years, 20 (87%) patients were alive, 2 (9%) developed posttransplant lymphoproliferative disorder, and 8 (35%) were hospitalized for infection within the first year. Waitlist and posttransplant outcomes were similar in patients with and without DS (P=non‐significant for all). Conclusions Waitlist and post‐HTx outcomes in children with DS selected for transplant listing are comparable to pediatric HTx recipients overall. Given acceptable outcomes, the presence of DS alone should not be considered an absolute contraindication to HTx.

【 授权许可】

Unknown