Survival and Risk Factors for Death After Cardiac Transplantation in Infants

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Abstract
Background Despite the increasing application of cardiac transplantation in infants, reported survival rates vary, and risk factors for death are poorly understood. Methods and Results To examine early survival and risk factors for death in infants (P=.0003), nonidentical blood type donor (P=.01), recipient non–blood group A (P=.02), and donor cause of death other than closed head trauma (P=.04). Diagnosis at listing, waiting time (mean, 1.3 months), graft ischemic time (mean, 228 minutes; range, 68 to 479 minutes), and recipient ventilatory or inotropic support at listing were not predictive for mortality after transplant. Conclusions The higher mortality rate observed with infant heart transplantation is due to a higher mortality within the first month after transplantation as a result of early graft failure. Strategies to improve donor heart function at implantation would have the greatest impact on survival after infant cardiac transplantation.