Evolution and Impact of Ventricular Assist Device Program on XXXX Awaiting Heart Transplantation.

@entity1 @entity1457 @entity7971
BACKGROUND: We sought to evaluate the impact of the evolution of a pediatric @entity1457 ( @entity1457 ) program on outcomes of @entity1 listed for heart transplantation at our institution. METHODS: All @entity1 listed for isolated heart transplantation from 1995 to 2013 were included. The use of @entity1457 while on the wait-list was recorded. Wait-list and posttransplant outcomes were compared before and after 2005, which was when we became capable of providing long-term @entity1457 without size limitation. RESULTS: In total, 259 @entity1 were listed for transplant and 201 (78%) reached transplant. The use of @entity1457 was significantly increased between the eras (13% and 37%, p  = 0.0001). Wait-list mortality was significantly decreased (25% and 11%, p  = 0.0006). Among transplant recipients, the proportion of @entity1 who underwent @entity1457 was significantly increased (13% and 37%, p  = 0.0002). Of these @entity1457 @entity1 , the use of long-term devices was significantly increased (50% and 98%, p  = 0.0004). Median duration of @entity1457 was significantly increased (12 and 78 days, p  = 0.004). Kaplan-Meier estimates showed a trend (p  = 0.08) toward improved survival after bridge-to-transplant both at 1 year (70% in the early @entity7971 and 88% in the late @entity7971 ) and at 5 years (60% and 78%, respectively). CONCLUSIONS: Outcomes of pediatric heart transplantation have significantly improved over the last 2 decades. We believe such improvement is, at least in part, attributable to maturation of @entity1457 strategy, characterized by avoiding the use of temporary devices such as extracorporeal membrane oxygenation as a bridge-to-transplant and a more aggressive use of long-term devices.
