A new research suggests children should receive a heart transplant as soon as a suitable donor is available. The new research was led by Dr. Brian Feingold of the Children’s Hospital of Pittsburgh and the University of Pittsburgh School of Medicine in Pennsylvania and was recently presented at the American Heart Association’s (AHA) Scientific Sessions 2014.
In other words the children who receive a heart transplant as soon as a suitable donor is available are predicted to have better quality-adjusted survival, even if they have antibodies that may attack the new heart than the children who wait for a donor to which they do not have antibodies. Moreover transplantation with the first suitable heart is also cheaper than waiting for a better-matched organ, researchers added.
Researchers assessed 10-year survival among more than 2,700 children in the United States after they were put on the heart transplant list. The patients’ average age was 5, and 55 percent were male. 62 percent were white, 23 percent were black and 15 percent were Hispanic. About half of the children were born with heart disease and all urgently needed a heart transplant. And the results showed that taking the first available donor heart increased survival time by more than one year, compared to waiting for a heart based on antibody status.
“Our analysis shows that denial of listing for transplant, solely on the basis of having too many antibodies, is unwarranted. One of the next questions is whether low levels of antibodies identified using modern antibody detection techniques are clinically meaningful. Are they a harbinger of problems to come, or just a ‘false positive’ that potentially alters our care of patients with important effects on survival and costs of care?”
Study lead author Dr. Brian Feingold, medical director of Pediatric Heart and Heart-Lung Transplantation at Children’s Hospital of Pittsburgh, said in an AHA news release.
So the researchers did not examine rejection rates of the transplanted hearts or outcomes among heart transplant patients who did not have antibodies.
A patient may need a heart transplant for several reasons, including improperly functioning ventricles or heart failure. When a child receives one, the transplanted heart grows to adult size as the child grows. He or she will then need to take immunosuppressive medications and other medicine for the rest of their life in order to control the transplant’s side effects.
