ArticleThe Journal of thoracic and cardiovascular surgery2019
Increased mortality, morbidities, and costs after heart transplantation in heterotaxy syndrome and other complex situs arrangements.
Article in The Journal of thoracic and cardiovascular surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 24 citations in OpenAlex.
- Long-term pediatric heart transplantation.JHLT open · 2026Article
- Caval translocation as a surgical strategy for patients with congenital heart disease and bilateral superior vena cava.JTCVS techniques · 2025Article
- The complex and hazardous course for heterotaxy-associated congenital heart disease.JTCVS open · 2025Article
- Orthotopic heart transplantation in patient with situs inversus and pectus excavatum: a case report.Surgical case reports · 2024Article
- Contemporary Outcomes of Heart Transplantation in Children with Heterotaxy Syndrome: Sub-Optimal Pre-Transplant Optimization Translates into Early Post-Transplant Mortality.Pediatric cardiology · 2024Article
- Predictive factors contributing to prolonged recovery in patients after Fontan operation.BMC pediatrics · 2022Article
- Expanding analytic possibilities in pediatric solid organ transplantation through linkage of administrative and clinical registry databases.Pediatric transplantation · 2019Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesIdentify pediatric heart transplant (HT) recipients with heterotaxy and other complex arrangements of cardiac situs (heterotaxy/situs anomaly) and compare mortality, morbidities, length of stay (LOS), and costs to recipients with congenital heart disease without heterotaxy/situs anomaly.
methodsUsing linked registry data (2001-2016), we identified 186 HT recipients with heterotaxy/situs anomaly and 1254 with congenital heart disease without heterotaxy/situs anomaly. We compared post-HT outcomes in univariable and multivariable time-to-event analyses. LOS and cost from HT to discharge were compared using Wilcoxon rank-sum tests. Sensitivity analyses were performed using stricter heterotaxy/situs anomaly group inclusion criteria and through propensity matching.
resultsHT recipients with heterotaxy/situs anomaly were older (median age, 5.1 vs 1.6 years; P < .001) and more often black, Asian, Hispanic, or "other" nonwhite (54% vs 32%; P < .001). Heterotaxy/situs anomaly was independently associated with increased mortality (hazard ratio, 1.58; 95% confidence interval, 1.19-2.09; P = .002), even among 6-month survivors (hazard ratio, 1.86; 95% confidence interval, 1.09-3.16; P = .021). Heterotaxy/situs anomaly recipients more commonly required dialysis (odds ratio, 2.58; 95% confidence interval, 1.51-4.42; P = .001) and cardiac reoperation (odds ratio, 1.91; 95% confidence interval, 1.17-3.11; P = .010) before discharge. They had longer ischemic times (19.2 additional minutes [range, 10.9-27.5 minutes]; P < .001), post-HT intensive care unit LOS (16 vs 13 days; P = .012), and hospital LOS (26 vs 23 days; P = .005). Post-HT hospitalization costs were also greater ($447,604 vs $379,357; P = .001).
conclusionsHeterotaxy and other complex arrangements of cardiac situs are associated with increased mortality, postoperative complications, LOS, and costs after HT. Although increased surgical complexity can account for many of these differences, inferior late survival is not well explained and deserves further study.
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