Probabilities of heart donors arising within specified times for child recipients

Abstract

Expectation of suitable heart donation arising within 40 days for needful recipients in Australia is low for infants (probability <0.3), moderate for small children (probability 0.5-0.9) and modest for large children (probability 0.4-0.7), with variation at all body weights according to blood group and waiting time.

Paediatric heart transplantation in Australia comes of age: 21 years of experience in a national centre

“…Infants in our study had the highest mortality on the waiting list, with 47% dying prior to HT. While the probability of infants in Australia receiving a suitable heart donation in a timely manner is low, infants are eligible for a variety of emerging strategies to reduce waiting list mortality. ABO‐incompatible HT has evolved from an experimental strategy into established therapy with the potential for significant reduction in waiting times and mortality .…”

“…Transplantation medicine in Australia and New Zealand is impacted by small population with low organ donation rates leading to long waiting times. This phenomenon is exacerbated in children who until recently had limited options for mechanical circulatory support . HT has therefore been limited as a viable first‐line option for babies born with severe CHD, such as hypoplastic left heart syndrome (HLHS).…”

Australian Experience with VAD as a Bridge to Paediatric Cardiac Transplantation

“…There has been no reported survival with ECMO used as a bridge to transplantation after three weeks of support. Because Australian children need longer time on the waiting list, we failed to bridge children to transplantation with ECMO support [5].…”

“…It allows increased physical activity, hospital discharge, and a reasonable quality of life [4]. Although extracorporeal membrane oxygenation (ECMO) has been used successfully in many paediatric cardiac transplant programs overseas, it's use was deemed unsuitable in Australia because of the extended waiting times in our country [5].…”

Pushing the boundaries: The current status of ABO-incompatible cardiac transplantation

“…[1][2][3] Infants often present in poor clinical condition and waiting list mortality is higher than in adults, 4,5 with figures of between 23% and 50% reported in some studies. 4 -6 Previously, solid-organ transplantation with blood group incompatibility between donors and recipients was contraindicated due to the risk of pre-formed isohemagglutinins causing hyperacute rejection.…”