BackgroundHeart transplantation is considered the gold standard therapy for the advanced
heart failure, but donor shortage, especially in pediatric patients, is the main
limitation for this procedure, so most sick patients die while waiting for the
procedure.ObjectiveTo evaluate the use of short-term circulatory support as a bridge to
transplantation in end-stage cardiomyopathy.MethodsRetrospective clinical study. Between January 2011 and December 2013, 40 patients
with cardiomyopathy were admitted in our Pediatric Intensive Care Unit, with a
mean age of 4.5 years. Twenty patients evolved during hospitalization with
clinical deterioration and were classified as Intermacs 1 and 2. One patient died
within 24 hours and 19 could be stabilized and were listed. They were divided into
2 groups: A, clinical support alone and B, implantation of short-term circulatory
support as bridge to transplantation additionally to clinical therapy.ResultsWe used short-term mechanical circulatory support as a bridge to transplantation
in 9. In group A (n=10), eight died waiting and 2 patients (20%) were
transplanted, but none was discharged. In group B (n=9), 6 patients (66.7%) were
transplanted and three were discharged.The mean support time was 21,8 days (6 to
984h). The mean transplant waiting list time was 33,8 days. Renal failure and
sepsis were the main complication and causeof death in group A while neurologic
complications were more prevalent en group B.ConclusionMechanical circulatory support increases survival on the pediatric heart
transplantation waiting list in patients classified as Intermacs 1 and 2.
