Abstract 2635: Characteristics of Pediatric Heart Donors and Implications for Post-Transplant Survival: An Analysis of the United Network of Organ Sharing Database: 1990–2004
Background: The pediatric donor heart population and the impact of donor characteristics on transplant (Tx) outcome have not been well characterized.
Methods: De-identified data was provided by United Network for Organ Sharing for 9,350 heart donors (age<19yr) between 1990 and 2004. The impact of the cause and mechanism of death on survival at one-year post-Tx was determined. Donor availability was compared among three eras (1990 –1994, 1995–1999, 2000 –2004).
Results: Donor characteristics are summarized in Table 1⇓. The most common cause of death was head trauma and the most common mechanism of death was blunt injury. The cause of death was not significantly associated with post-Tx survival. Death due to GSW was associated with improved one-year survival post-Tx compared to ICH (11% vs. 16%, respectively, p=0.03) and was not different from BI (14%, p=0.06). Odds ratio was 1.22 for improved survival in GSW and 0.81 for ICH compared to BI. The number of pediatric donors per annum has decreased significantly from 1994 –2004 (p <0.001), while the number of pediatric recipients per annum significantly increased over the same time (p=0.026). The decrease occurred in donors age > yrs (p<0.01) while the number of donors age ≤1 increased (p<0.03).
Conclusions: Tx survival at one-year was significantly better when a gunshot wound was the mechanism of death compared to intracranial hemorrhage. The number of pediatric heart donors has significantly decreased in the recent era, highlighting the need to intensify efforts to expand the donor pool.