Health-related quality of life after pediatric heart transplantation in early childhood

Gonzalo Garcia Guerra; Gwen Y Bond; Ari R Joffe; Irina A Dinu; Morteza Hajihosseini; Mohammed Al-Aklabi; Charlene M T Robertson; Simon Urschel; Western Canadian Complex Pediatric Therapies Follow-up Program

doi:10.1111/petr.13822

Health-related quality of life after pediatric heart transplantation in early childhood

Pediatr Transplant. 2020 Nov;24(7):e13822. doi: 10.1111/petr.13822. Epub 2020 Sep 1.

Authors

Gonzalo Garcia Guerra¹, Gwen Y Bond², Ari R Joffe¹, Irina A Dinu³, Morteza Hajihosseini³, Mohammed Al-Aklabi⁴, Charlene M T Robertson^{1

2}, Simon Urschel⁵; Western Canadian Complex Pediatric Therapies Follow-up Program

Affiliations

¹ Department of Pediatrics, Division of Pediatric Critical Care, University of Alberta, Edmonton, Alberta, Canada.
² Department of Pediatrics, Glenrose Rehabilitation Hospital, University of Alberta, Edmonton, AB, Canada.
³ School of Public Health, University of Alberta, Edmonton, AB, Canada.
⁴ Department of Surgery, University of Alberta, Edmonton, AB, Canada.
⁵ Division of Pediatric Cardiology, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.

PMID: 32871049
DOI: 10.1111/petr.13822

Abstract

Background: There is limited information about HRQL after pediatric heart transplantation at a young age.

Methods: Prospective follow-up study of children who received a heart transplant at age ≤4 years. HRQL was assessed using the PedsQL^TM 4.0 at age 4.5 years. This cohort was compared with healthy children, children with CHD, and with chronic conditions. Peri-operative factors associated with HRQL were also explored.

Results: Of 66 eligible patients, 15 (23%) died prior to the HRQL assessment and 2 (3%) were lost to follow-up, leaving 49 patients. Indication for transplantation was CHD in 27 (55%) and CMP in 22 (45%). Median age (IQR) at transplant was 9 (5-31) months. HRQL was significantly lower in transplanted children compared to population norms (65.3 vs 87.3, P < .0001), children with chronic conditions (65.3 vs 76.1, P = .001), and children with CHD (65.3 vs 81.1, P < .0001). Transplanted children with CHD had lower HRQL than those with a prior diagnosis of CMP (59.5 vs 72.5, P-value = .020). Higher creatinine pretransplant and higher lactate post-operatively were associated with lower HRQL.

Conclusion: Children after heart transplant had significantly lower HRQL, as reported by their parents, than the normative population, children with chronic conditions, and children with CHD.

Keywords: heart transplant; outcome; pediatric transplantation; quality of life.

Publication types

Multicenter Study

MeSH terms

Female
Follow-Up Studies
Health Status*
Heart Transplantation / psychology*
Humans
Infant
Male
Postoperative Period
Prospective Studies
Quality of Life / psychology*
Time Factors