Pediatric heart transplant waiting times rose during pandemic, but mortality did not
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During the COVID-19 pandemic, the waiting list times for pediatric heart transplants were longer than before the pandemic, but waiting list mortality did not change, according to a research letter published in JAMA Network Open.
The researchers compared 610 children (mean age, 6.93 years) who received a heart transplant during the pandemic period, defined as March 2020 to June 2021, with 626 children (mean age, 6.74 years) who received a heart transplant during the pre-pandemic period, defined as November 2018 to February 2020.
Most recipient and donor characteristics were similar between the groups, but recipients during the pandemic period were less likely to have ventilatory support before transplant than those during the pre-pandemic period (7% vs. 12%; P = .01), John Iguidbashian, MD, a general surgery resident at the University of Colorado School of Medicine, and colleagues wrote.
Mean waiting list time was 157.4 days during the pandemic compared with 126 days before the pandemic (mean difference, 32 days; 95% CI, 0.3-63; P = .05), the researchers wrote.
Waiting list survival, posttransplant survival and graft survival were all comparable between the pandemic period and the pre-pandemic period, Iguidbashian and colleagues found.
Mean postoperative length of stay was shorter in the pandemic group than in the pre-pandemic group (31 days vs. 40 days; mean difference, –9 days; 95% CI, –15 to –4; P = .001), according to the researchers.
“These findings are a testament to multidisciplinary initiatives to sustain delivery of care among this vulnerable patient population, as children with end-stage heart failure have high rates of waiting list mortality secondary to limited donor organ availability,” Iguidbashian and colleagues wrote. “Although our findings suggest that heart transplant outcomes have been maintained during the pandemic, continued diligence is warranted. Survival and quality of life among children awaiting heart transplants will depend on a collaborative commitment to standardized decision-making and critical outcomes analysis.”
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