Kids Who Need Heart Transplant Should Get the First Available, Study Says

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WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- Children who need a heart transplant may be better off if they get a new heart as soon as possible rather than waiting for a perfect match, according to a new study.

Researchers assessed 10-year survival among more than 2,700 children in the United States after they were put on the heart transplant list. Some of the kids received the first suitable heart, even if they had immune system antibodies that might lead to rejection of the new organ. Other children waited for a heart to which they did not have antibodies.

The patients' average age was 5, and 45 percent were female. More than half were white, 23 percent were black and 15 percent were Hispanic. About half of the children were born with heart disease and all urgently needed a heart transplant.

The results showed that taking the first available donor heart increased survival time by more than one year, compared to waiting for a heart based on antibody status.

Accepting the first available heart also cost an average of $122,856 less per patient than waiting, according to the study, which was to be presented Wednesday at the American Heart Association's annual meeting in Chicago.

The researchers did not examine rejection rates of the transplanted hearts or outcomes among heart transplant patients who did not have antibodies.

"Our analysis shows that denial of listing for transplant, solely on the basis of having too many antibodies, is unwarranted," study lead author Dr. Brian Feingold, medical director of Pediatric Heart and Heart-Lung Transplantation at Children's Hospital of Pittsburgh, said in an AHA news release.

He added: "One of the next questions is whether low levels of antibodies identified using modern antibody detection techniques are clinically meaningful. Are they a harbinger of problems to come, or just a 'false positive' that potentially alters our care of patients with important effects on survival and costs of care?"

As many as 20 percent of children waiting for a heart transplant may have antibodies, noted Feingold, who is an associate professor of the University of Pittsburgh School of Medicine.

As of June 2013, nearly 3,500 people in the United States were waiting for a heart transplant, according to the AHA.

Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

More information

The U.S. National Heart, Lung, and Blood Institute has more about heart transplant.