Impact of prolonged waiting times of neonates awaiting heart transplantation

J Perinatol. 1997 Nov-Dec;17(6):481-8.

Abstract

Objectives: This study analyzed waiting times and outcomes of neonates listed for heart transplantation at two medical centers from 1991 through 1994.

Study design: Retrospective analysis was performed to examine waiting times, charges, morbidity, and outcomes.

Results: Of the 30 neonates listed for transplantation, 15 received hearts, with 10 late survivors. Waiting time increased from 25 +/- 8 days in 1991 and 1992 to 58 +/- 7 days in 1993 and 1994 (p < 0.01), and the hospital charge per patient increased from $118,300 +/- $31,500 to $198,700 +/- $25,400 (p < 0.05). Freedom from sepsis predicted receiving heart transplantation (p < 0.01). Lack of a preoperative central intravenous catheter, no preoperative mechanical ventilation, and A-negative blood type predicted heart transplantation survival (p < 0.05). The chances of receiving and surviving transplantation were the same in the two periods. There was a trend toward greater morbidity among neonates waiting more than 35 days.

Conclusions: Waiting times and charges have increased significantly over the last 4 years. Patients who are free of sepsis, lack a preoperative central intravenous catheter, are not mechanically ventilated preoperatively, and have A-negative blood type have better outcomes.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study

MeSH terms

  • Graft Survival
  • Heart Defects, Congenital / economics
  • Heart Defects, Congenital / epidemiology
  • Heart Defects, Congenital / surgery*
  • Heart Transplantation* / economics
  • Heart Transplantation* / mortality
  • Hospital Charges / trends
  • Humans
  • Infant Mortality
  • Infant, Newborn
  • Morbidity
  • Predictive Value of Tests
  • Retrospective Studies
  • Time Factors
  • Tissue Donors / supply & distribution
  • Treatment Outcome
  • Waiting Lists*