Hypoalbuminemia and poor growth predict worse outcomes in pediatric heart transplant recipients

Chesney Castleberry, Connie White-Williams, David Naftel, Margaret A. Tresler, Elizabeth Pruitt, Shelley D. Miyamoto, Debbie Murphy, Robert Spicer, Louise Bannister, Kenneth Schowengerdt, Lisa Gilmore, Beth Kaufman, Steven Zangwill

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12 Scopus citations

Abstract

Children with end-stage cardiac failure are at risk of HA and PG. The effects of these factors on post-transplant outcome are not well defined. Using the PHTS database, albumin and growth data from pediatric heart transplant patients from 12/1999 to 12/2009 were analyzed for effect on mortality. Covariables were examined to determine whether HA and PG were risk factors for mortality at listing and transplant. HA patients had higher waitlist mortality (15.81% vs. 10.59%, p = 0.015) with an OR of 1.59 (95% CI 1.09-2.30). Survival was worse for patients with HA at listing and transplant (p ≤ 0.01 and p = 0.026). Infants and patients with congenital heart disease did worse if they were HA at time of transplant (p = 0.020 and p = 0.028). Growth was poor while waiting with PG as risk factor for mortality in multivariate analysis (p = 0.008). HA and PG are risk factors for mortality. Survival was worse in infants and patients with congenital heart disease. PG was a risk factor for mortality in multivariate analysis. These results suggest that an opportunity may exist to improve outcomes for these patients by employing strategies to mitigate these risk factors.

Original languageEnglish (US)
Pages (from-to)280-287
Number of pages8
JournalPediatric Transplantation
Volume18
Issue number3
DOIs
StatePublished - 2014

Keywords

  • heart transplant
  • hypoalbuminemia
  • nutrition
  • outcomes
  • pediatric
  • weight

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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    Castleberry, C., White-Williams, C., Naftel, D., Tresler, M. A., Pruitt, E., Miyamoto, S. D., Murphy, D., Spicer, R., Bannister, L., Schowengerdt, K., Gilmore, L., Kaufman, B., & Zangwill, S. (2014). Hypoalbuminemia and poor growth predict worse outcomes in pediatric heart transplant recipients. Pediatric Transplantation, 18(3), 280-287. https://doi.org/10.1111/petr.12239