(Press-News.org) Children who receive a heart transplant as soon as a suitable donor is available are predicted to have better quality-adjusted survival -- even if they have antibodies that may attack the new heart -- than children who wait for a donor to which they do not have antibodies according to research presented at the American Heart Association's Scientific Sessions 2014.
When the costs of care while waiting for an urgent transplant are considered, transplantation with the first suitable heart is also cheaper than waiting for a better-matched organ, researchers said.
In the same way that a vaccine activates the body's immune response to fight off a virus, a donated organ can trigger antibodies to fight off foreign tissue. Because of the risk of severe rejection after transplantation, experts traditionally believed that children with these antibodies should wait for a heart that won't activate an antibody response.
But patients with the antibodies in their blood are at high risk of dying while waiting for a perfect match, said Brian Feingold, M.D., M.S., study lead author and medical director of Pediatric Heart and Heart-Lung Transplantation at Children's Hospital of Pittsburgh of UPMC and associate professor of the University of Pittsburgh School of Medicine in Pennsylvania.
He noted that as many as 20 percent of children waiting for a heart transplant may have antibodies.
Researchers examined data of more than 2,700 children listed for transplant since 1999.Patients' average age was 5 years and 45 percent were female. More than half were Caucasian, 23 percent were African American and 15 percent were Hispanic. About half of the children were born with heart disease and all urgently needed a heart transplant.
Researchers compared 10-year survival after being listed for transplant using two opposing strategies: waiting for a donor heart to which the candidate does not have antibodies or taking the first suitable offer, regardless of potential problems that antibodies may pose. The study found that accepting the first suitable offer, regardless of antibody concerns, is predicted to:
increase survival from the time of listing by more than 1 year (adjusted for quality of life) as compared to waiting for transplantation based on antibody status.
cost an average $122,856 less than waiting for transplantation based on antibody status.
"Our analysis shows that denial of listing for transplant, solely on the basis of having too many antibodies, is unwarranted," Feingold said. "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?"
For their study, researchers obtained 1999-2009 patient data from the Organ Procurement and Transplantation Network. Cost data came from the Children's Hospital of Pittsburgh of UPMC and the public Healthcare Cost Utilization Project Kids' Inpatient Database.
Researchers were able to control for antibody status, wait-list time and wait-list survival, post-transplant survival in the presence or absence of a positive crossmatch, and costs. They didn't specifically examine rejection rates, nor did they examine treatments other than heart transplant or outcome among patients without antibodies.
As of June 2013, nearly 3,500 patients were waiting for a heart transplant, according to American Heart Association statistics.
INFORMATION:
Co-authors are Steven A. Webber, M.B.Ch.B., M.R.C.P.; Cindy L. Bryce, Ph.D.; Heather E. Tomko, M.S.; Seo Y. Park, Ph.D.; William T. Mahle, M.D.; and Kenneth J. Smith, M.D. Author disclosures are on the manuscript.
The National Center for Advancing Translational Sciences and the National Institutes of Health funded the study.
Additional Resources
Downloadable video/audio interviews, B-roll, animation and images related to this news release are on the right column of the release link http://newsroom.heart.org/news/speedy-heart-transplant-for-kids-better-than-waiting-for-perfect-match?preview=7c2fce7ca76a9cfcf60678f7936914cc
Video clips with researchers/authors of the studies will be added to the release link after embargo.
Heart transplants in children
Surgical Procedures for Heart Failure
For more news from AHA's Scientific Sessions, follow us on Twitter @HeartNews #AHA14.
Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at http://www.heart.org/corporatefunding.
Note: Presentation is 9:15 a.m. CT /10:15 a.m. ET, Wednesday, Nov. 19, 2014 (S102d, Core 3).
For Media Inquiries
AHA News Media in Dallas: (214) 706-1173
AHA News Media Office, Nov. 15-19,
at the McCormick Place Convention Center: (312) 949-3400
For Public Inquiries: (800) AHA-USA1 (242-8721)
heart.org and strokeassociation.org
Life is why we fund scientific breakthroughs that save and improve lives.
An experimental 3-dimensional printed model of the heart may help surgeons treat patients born with complicated heart disorders, according to research presented at the American Heart Association's Scientific Sessions 2014.
Most heart surgeons use 2D images taken by X-ray, ultrasound and MRI for surgical planning. However, these images may not reveal complex structural complications in the heart's chambers that occur when heart disease is present at birth (congenital heart defects), as opposed to developing later in life within a structurally normal heart.
But with standard ...
CHICAGO - Women who take a common type of medication to control their blood pressure are not at increased risk of developing breast cancer due to the drug, according to new study by researchers at the Intermountain Medical Center Heart Institute in Murray, Utah.
Researchers analyzed the records of more than 3,700 women who had no history of breast cancer, and who had long-term use of calcium channel blocker medications to control their blood pressure. Researchers found only a minimal increase in risk in one study and a 50 percent reduced risk in a second, leading them ...
Chicago, Ill. - November 19, 2014 - A powerful new app is directly connecting single ventricle heart defect patients to their doctors, dramatically improving their monitoring while they recover from heart surgery at home. Girish Shirali, MBBS, FACC, FASE, Co-Director of the Ward Family Heart Center at Children's Mercy Kansas City, will report today on how the technology is changing patient care at the American Heart Association Scientific Sessions 2014.
The tablet-based app, called CHAMP (Cardiac High-Acuity Monitoring Program), is a more automated, accurate and simplified ...
A study at Hospital for Special Surgery (HSS) finds that a support group addressing the psychological and educational needs of people recently diagnosed with rheumatoid arthritis (RA) has a strong positive impact on their lives.
Ninety percent of participants indicated that as a result of the free group, they could make informed choices about their RA. The study findings were presented in the "Innovations in Rheumatologic Care" session at the American College of Rheumatology annual meeting on November 19 in Boston.
"The Early RA Support and Education program, a part ...
Retrieving memory content under stress does not work very well. However, stress can be helpful when it comes to saving new information -- especially those that are emotionally relevant in stressful situations. At the Ruhr-Universitat Bochum, a team of cognitive psychologists headed by Prof Dr Oliver T. Wolf study these correlations. The RUB's science magazine RUBIN reports on the results.
Faked Job Interview Triggers Stress
The team tested how well people remember items from a faked job interview that was conducted either in a friendly or a stress-triggering atmosphere ...
Electronic cigarettes offer smokers a realistic way to kick their tobacco smoking addiction. In a new study published in the International Journal of Environmental Research and Public Health, scientists at KU Leuven report that e-cigarettes successfully reduced cravings for tobacco cigarettes, with only minimal side effects.
Electronic cigarettes (e-cigs) were developed as a less harmful alternative to tobacco cigarettes. They contain 100 to 1,000 times less toxic substances and emulate the experience of smoking a tobacco cigarette.
In an 8-month study, the KU Leuven ...
COLUMBIA, MD and WASHINGTON, DC (November 19, 2014) - Today, the National Center for Healthy Housing (NCHH) and Milken Institute School of Public Health at the George Washington University released Healthcare Financing of Healthy Homes Services: Findings from a 2014 Survey of State Reimbursement Policies, a report documenting current Medicaid reimbursement practices for environmental health services in the homes of lead-exposed children and people with asthma and highlighting opportunities for increasing access to these benefits.
"ASTHO applauds NCHH and Milken Institute ...
In his general theory of relativity, Albert Einstein predicted that there are such things as gravitational waves. In fact, the very existence of these waves is the linchpin of the entire theory. Despite the great lengths that physicists have gone to in recent decades, however, they still have not managed to detect them directly with a measurement. This could largely be due to the fact that this requires a level of precision that it is practically impossible to achieve with today's measuring devices. Ultimately, it is all about measuring the tiniest of compressions and extensions ...
WASHINGTON, Nov. 19, 2014--When the 2014 Nobel Prize in physics was awarded this October to three Japanese-born scientists for the invention of blue light emitting diodes (LEDs), the prize committee declared LED lamps would light the 21st century. Now researchers from the Netherlands have found a novel way to ensure the lights of the future not only are energy efficient but also emit a cozy warmth.
"We demonstrated a seemingly simple - but in fact sophisticated - way to create LED lights that change in a natural way to a cozy, warm white color when dimmed," said Hugo ...
Blueberries are super stars among health food advocates, who tout the fruit for not only promoting heart health, better memory and digestion, but also for improving night vision. Scientists have taken a closer look at this latter claim and have found reason to doubt that the popular berry helps most healthy people see better in the dark. Their report appears in ACS' Journal of Agricultural & Food Chemistry.
Wilhelmina Kalt and colleagues note that studies published decades ago provided the first hints that blueberries might improve people's night vision. Later lab experiments ...
