Prolonged LOS After Heart Transplant More Common in Children with Congenital Disease

Researchers found that ECMO before transplant tripled chance of a long hospital stay

Length of stay is used as a quality metric, but there’s no definition of prolonged length of stay after pediatric heart transplantations. Moreover, the factors affecting length of stay after a transplant are poorly understood,say researchers who examined the association of prolonged stays with heart transplant outcomes. Dipankar Gupta, MD, and his colleagues presented their findings at the American Heart Association Scientific Sessions meeting in Philadelphia in November. 

They analyzed 4,414 cases in the Pediatric Heart Transplant Society database. They found that the median stay was 19 days. A length of stay longer than 30 days was defined as prolonged; by that definition, 1,313 patients (30%) had prolonged stays. 

Prolonged stays were more common for patients with congenital heart disease (60%) and less so for patients cardiomyopathy (36%), according to Gupta and his colleague's research. The factors predicting prolonged stays included mechanical ventilation, previous surgery, history of CPR, age younger than one year, and renal dysfunction. Ventricular assist device use nearly doubled the risk; extracorporeal membrane oxygenation before a heart transplant tripled it.

The researchers also found that patients with length of stays shorter than 30 days were more likely to survive at 1, 3, and 5 years than patients with prolonged stays.