Division of Pediatric Cardiology, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
Pediatr Transplant. 2024 Feb;28(1):e14615. doi: 10.1111/petr.14615. Epub 2023 Oct 9.
The Pediatric Heart Transplant Society (PHTS) Registry was founded 30 years ago as a collaborative effort among like-minded providers of this novel life-saving technique for children with end-stage heart failure. In the intervening decades, the data from the Registry have provided invaluable knowledge to the field of pediatric heart transplantation. This report of the PHTS Registry provides a comprehensive look at the data, highlighting both the longevity of the registry and one unique aspect of the PHTS registry, allowing for exploration into children with single ventricle anatomy.
The PHTS database was queried from January 1, 1993 to December 31, 2019 to include pediatric (age < 18 years) patients listed for HT. For our analysis, we primarily analyzed patients by era. The early era was defined as children listed for HT from January 1, 1993 to December 31, 2004; middle era January 1, 2005 to December 31, 2009; and recent era January 1, 2010 to December 31, 2019. Outcomes after listing and transplant, including mortality and morbidities, are presented as unadjusted for risk, but compared across eras.
Since 1993, 11 995 children were listed for heart transplant and entered into the PHTS Registry with 9755 listed during the study period. The majority of listings occurred within the most recent era. Waitlist survival improved over the decades as did posttransplant survival. Other notable changes over time include fewer patients experiencing allograft rejection or infection after transplant. Waitlist and posttransplant survival have changed dramatically in patients with single ventricle physiology and significantly differ by stage of single ventricle palliation.
Key points from this PHTS Registry summary and focus on patients with single ventricle congenital heart disease in particular, include the changing landscape of candidates and recipients awaiting heart transplant. There is clear improvement in waitlist and transplant outcomes for children with both cardiomyopathy and congenital heart disease alike.
儿科心脏移植协会（PHTS）登记处成立于 30 年前，是一群志同道合的专业人士共同努力的结果，他们致力于为患有终末期心力衰竭的儿童提供这种新颖的救命技术。在过去的几十年里，该登记处的数据为儿科心脏移植领域提供了宝贵的知识。本报告介绍了 PHTS 登记处的数据，全面展示了该登记处的历史和一个独特的方面，即允许探索单心室解剖结构的儿童。
从 1993 年 1 月 1 日至 2019 年 12 月 31 日，查询 PHTS 数据库，以纳入接受 HT 治疗的儿科（年龄<18 岁）患者。在我们的分析中，我们主要按时代分析患者。早期定义为 1993 年 1 月 1 日至 2004 年 12 月 31 日接受 HT 治疗的儿童；中期为 2005 年 1 月 1 日至 2009 年 12 月 31 日；近期为 2010 年 1 月 1 日至 2019 年 12 月 31 日。列出和移植后的结果，包括死亡率和发病率，未经风险调整，但在不同时代进行比较。
自 1993 年以来，共有 11995 名儿童接受心脏移植，并被纳入 PHTS 登记处，其中 9755 名在研究期间被列入登记处。大多数列表都出现在最近的时代。几十年来，候补者的生存率和移植后的生存率都有所提高。随着时间的推移，其他值得注意的变化包括接受移植后排斥反应或感染的患者人数减少。单心室生理学患者的候补者和移植后生存率发生了巨大变化，并且单心室姑息治疗阶段明显不同。
本 PHTS 登记处摘要的要点，特别是对患有单心室先天性心脏病的患者的关注，包括候补者和接受心脏移植的患者的情况不断变化。心肌病和先天性心脏病患者的候补者和移植后生存率都有明显提高。
