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Pediatric Heart Transplantation within the Scandiatransplant Region - A Multinational Observational Study Spanning 38 years

van der Have, Oscar LU orcid ; Tran-Lundmark, Karin LU ; Wåhlander, Håkan ; Kaskinen, Anu ; Möller, Thomas ; Juul, Klaus ; Jahnukainen, Timo ; Duus Weinreich, Ilse ; Sarkola, Taisto and Nilsson, Johan LU orcid , et al. (2025) In The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
Abstract

BACKGROUND: Thirty-eight years of pediatric heart transplantation (pHTx) within the Scandiatransplant organization were analyzed to describe volume trends, regional prevalence, underlying etiologies and outcomes following listing and pHTx.

METHODS: Children <18 years listed for pHTx from January 1st 1986 to December 31st 2023 were identified in the Scandiatransplant registry. The cohort was split into groups based on the era of listing (ERA I; 1986 - 1998, ERA II; 1999 - 2011, and ERA III; 2012 - 2023).

RESULTS: A total of 597 children were listed and 461 (77.2%) reached pHTx. The regional incidence of pHTx was 4.0 per 100,000 live births. All centers performed a median of <4 pHTx per year. 6.5% were transplanted at... (More)

BACKGROUND: Thirty-eight years of pediatric heart transplantation (pHTx) within the Scandiatransplant organization were analyzed to describe volume trends, regional prevalence, underlying etiologies and outcomes following listing and pHTx.

METHODS: Children <18 years listed for pHTx from January 1st 1986 to December 31st 2023 were identified in the Scandiatransplant registry. The cohort was split into groups based on the era of listing (ERA I; 1986 - 1998, ERA II; 1999 - 2011, and ERA III; 2012 - 2023).

RESULTS: A total of 597 children were listed and 461 (77.2%) reached pHTx. The regional incidence of pHTx was 4.0 per 100,000 live births. All centers performed a median of <4 pHTx per year. 6.5% were transplanted at less than one year of age. Waiting list duration increased over time, withdrawal frequency remained stable, and listing mortality decreased from 22.8% in ERA I to 6.8% in ERA III. The distribution of listing and transplant diagnoses were not different between eras. ABO-incompatible transplants increased over time, from 1.0% in ERA I to 8.8% in ERA III, as did transplant from ventricular assist devices (6.6% in ERA I, 19.9% in ERA III). Post-transplant survival was 78.0% at 10 years and 51.4% at 30 years. Survival was worse in patients with etiology of congenital heart disease compared with cardiomyopathies. Era of listing was determinant of listing mortality, but not of post-transplant survival.

CONCLUSIONS: Numbers of pHTx in the Scandiatransplant region are low but have increased with time. There has been a significant decrease in wait list mortality over time, whereas improvements in post-pHTx outcomes have been less evident, most likely due to excellent short-term outcomes for the first graft recipients in the region.

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Contribution to journal
publication status
epub
subject
in
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
publisher
Elsevier
external identifiers
  • pmid:40482845
ISSN
1557-3117
DOI
10.1016/j.healun.2025.05.020
language
English
LU publication?
yes
additional info
Copyright © 2025. Published by Elsevier Inc.
id
c18238b2-80ff-47fc-868e-852c5771eff7
date added to LUP
2025-06-08 15:32:10
date last changed
2025-06-09 08:23:06
@article{c18238b2-80ff-47fc-868e-852c5771eff7,
  abstract     = {{<p>BACKGROUND: Thirty-eight years of pediatric heart transplantation (pHTx) within the Scandiatransplant organization were analyzed to describe volume trends, regional prevalence, underlying etiologies and outcomes following listing and pHTx.</p><p>METHODS: Children &lt;18 years listed for pHTx from January 1st 1986 to December 31st 2023 were identified in the Scandiatransplant registry. The cohort was split into groups based on the era of listing (ERA I; 1986 - 1998, ERA II; 1999 - 2011, and ERA III; 2012 - 2023).</p><p>RESULTS: A total of 597 children were listed and 461 (77.2%) reached pHTx. The regional incidence of pHTx was 4.0 per 100,000 live births. All centers performed a median of &lt;4 pHTx per year. 6.5% were transplanted at less than one year of age. Waiting list duration increased over time, withdrawal frequency remained stable, and listing mortality decreased from 22.8% in ERA I to 6.8% in ERA III. The distribution of listing and transplant diagnoses were not different between eras. ABO-incompatible transplants increased over time, from 1.0% in ERA I to 8.8% in ERA III, as did transplant from ventricular assist devices (6.6% in ERA I, 19.9% in ERA III). Post-transplant survival was 78.0% at 10 years and 51.4% at 30 years. Survival was worse in patients with etiology of congenital heart disease compared with cardiomyopathies. Era of listing was determinant of listing mortality, but not of post-transplant survival.</p><p>CONCLUSIONS: Numbers of pHTx in the Scandiatransplant region are low but have increased with time. There has been a significant decrease in wait list mortality over time, whereas improvements in post-pHTx outcomes have been less evident, most likely due to excellent short-term outcomes for the first graft recipients in the region.</p>}},
  author       = {{van der Have, Oscar and Tran-Lundmark, Karin and Wåhlander, Håkan and Kaskinen, Anu and Möller, Thomas and Juul, Klaus and Jahnukainen, Timo and Duus Weinreich, Ilse and Sarkola, Taisto and Nilsson, Johan and Odermarsky, Michal}},
  issn         = {{1557-3117}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Elsevier}},
  series       = {{The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation}},
  title        = {{Pediatric Heart Transplantation within the Scandiatransplant Region - A Multinational Observational Study Spanning 38 years}},
  url          = {{http://dx.doi.org/10.1016/j.healun.2025.05.020}},
  doi          = {{10.1016/j.healun.2025.05.020}},
  year         = {{2025}},
}