scholarly journals Donor Characteristics and Recipient Outcomes After Heart Transplantation in Adult Congenital Heart Disease

2021 ◽  
Author(s):  
Geoffrey D. Huntley ◽  
David A. Danford ◽  
Jonathan Menachem ◽  
Shelby Kutty ◽  
Ari M. Cedars
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Heart Transplantation ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
The United States ◽  
Donor Selection ◽  
Hazard Models ◽  
Adult Congenital ◽  
Donor Characteristics

Background Patients with adult congenital heart disease (ACHD) experience long waitlist times for heart transplantation (HTx) while a large proportion of donor hearts are refused. The goal of this study was to inform optimal donor selection for patients with ACHD listed for HTx by examining the impact of donor characteristics on post‐HTx outcomes. Methods and Results Using the Scientific Registry of Transplant Recipients, we conducted a retrospective analysis of patients aged ≥18 years listed for HTx in the United States between 2000 and 2016. We compared waitlist times between patients with ACHD and patients with noncongenital heart disease and constructed multivariate hazard models to identify donor characteristics associated with increased waitlist time. We then compared post‐HTx survival between patients with ACHD and patients with noncongenital heart disease and constructed multivariate hazard models to identify donor characteristics associated with mortality. There were very few differences in donor characteristics between HTx recipients with ACHD and those with noncongenital heart disease. Status 1A–listed patients with ACHD experienced longer waitlist times compared with patients with noncongenital heart disease. Increased wait times were associated with some donor characteristics. Post‐HTx outcomes varied over time, with patients with ACHD having inferior early mortality (0 to 30 days), similar intermediate mortality (31 days to 4 years), and superior late mortality (>4 years). We identified no donor characteristics associated with mortality to justify the observed differences in donor selection or waitlist time. Conclusions HTx candidates with ACHD wait longer for transplant but do not require unique donor selection criteria. HTx teams should consider liberalizing donor criteria and focusing only on evidence‐based selection to improve waitlist outcomes and reduce the recipient–donor disparity.

Adult Congenital Heart Disease

2014 ◽  
pp. 870-880
Author(s):  
Yuli Y. Kim ◽  
Michael J. Landzberg ◽  
Anne Marie Valente
Keyword(s):  
United States ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Natural History ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
The United States ◽  
Complex Congenital Heart Disease ◽  
Clinical Presentations ◽  
Adult Congenital

Historically, individuals with complex congenital heart disease rarely lived past childhood. Due to tremendous advances in diagnosis and treatment, now 85–90% of children born with congenital heart disease will survive into adulthood. Estimates suggest that over 1 million adults with congenital heart disease currently live in the United States. The number of adults with congenital heart disease (ACHD) is growing by approximately 5% each year. The majority of these patients do not appear to be followed by ACHD specialists. Therefore, it is essential that all physicians familiarize themselves with the unique clinical presentations of these patients, including the anatomy, physiology, and natural history in order to facilitate proper management and referral.

scholarly journals Heart Transplantation for Adult Congenital Heart Disease: Overview and Special Considerations

2018 ◽  
Vol 3 (1) ◽  
pp. 73-84
Author(s):  
Dipankar Gupta ◽  
Jana Reid ◽  
Diego Moguillansky ◽  
Renata Shih ◽  
Mark S. Bleiweis ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Heart Transplantation ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Adult Congenital

Outcomes in adult congenital heart disease patients undergoing heart transplantation: A systematic review and meta-analysis

2016 ◽  
Vol 35 (11) ◽  
pp. 1337-1347 ◽  
Author(s):  
Barbara Stella Doumouras ◽  
Ana Carolina Alba ◽  
Farid Foroutan ◽  
Luke James Burchill ◽  
Anne I. Dipchand ◽  
...  
Keyword(s):  
Systematic Review ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Heart Transplantation ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Meta Analysis ◽  
Adult Congenital

scholarly journals Adults with Congenital Heart Disease in the Americas - Where we are today and where we are heading: A General View of the Inter-American Adult Congenital Heart Disease Council

2020 ◽  
pp. 1-5
Author(s):  
John Jairo Araujo ◽  
John Jairo Araujo
Keyword(s):  
United States ◽  
Congenital Heart Disease ◽  
Latin America ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
The United States ◽  
General View ◽  
Adult Congenital ◽  
The Caribbean

Congenital heart disease (CHD) in America has a global prevalence of 8-13 cases per 1,000 live births, with close to 45% being of medium and high complexity. Mortality continues to be high in Latin America and the Caribbean, with wide disparities in care, compared to North American countries. Fifty years ago, only 15% of children with CHD survived to age 18. Today, survival is greater than 90% in most countries worldwide. Currently, there are 2.2 million adults with congenital heart disease in the United States, with more than 1.8 million in South America. According to the Adult Congenital Heart Association, fewer than 10% of adults with congenital heart disease are estimated to be under specialized care, and more than 200 regional centers would be needed in the United States to meet the needs of this rapidly growing population. However, there are only 35 accredited programs in a total of 23 states. The scenario for Latin America and the Caribbean is bleaker and more distant, needing at least 249 programs, but lacking a formal census of centers and having few cardiologists who are experts in adult congenital heart disease. At the same time, there are insufficient paediatric cardiovascular centers. Thus, these countries have a double problem (children and adults with congenital heart disease, at the same time). In 2018, the Inter-American Society of Cardiology´s Inter-American Congenital Heart Disease Council was founded, which is working on various inter-American projects seeking to improve health care for adults with congenital heart disease.

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