Back to 2025 Abstracts
Comparison Of Outcomes Of Pediatric Heart Transplant Recipients Transplanted As Unos Status 1a With Impella Bridge To Transplantation Versus Other Mechanical Circulatory Support And No Support.
Rohit Ganduboina, MBBS1John M Karamichalis, MD, PhD
5, Omar Abdel Kerim, MPH
2, Gayatri Muley, MBBS, MS
3, Sandeep Sainathan, MD
4.
1NRI Institute of Medical Sciences, Visakhapatnam, India, 2University of Miami, Miami, FL, USA, 3Sir JJ Group of Hospitals, Mumbai, India, 4Department of Cardiac Surgery, University of Miami., Miami, FL, USA, 5Section of Pediatric and Congenital Cardiac Surgery, Columbia University Medical Center, New York, NY, USA
Objective(s):Mechanical circulatory support (MCS) is critical for pediatric status 1A heart transplant candidates. However, outcomes with newer devices like Impella remain underexplored compared to ECMO and durable VADs.
Methods:2681 pediatric status 1A transplant recipients from UNOS database (2017-2025) were, categorized by MCS type: Impella (46, 1.7%), ECMO (119, 4.4%), durable VAD (914, 34.1%), or no MCS (1602, 59.7%). Data was assessed using standard statistical methods.
Results:Impella and ECMO use remained low relative to durable VADs, with overall MCS utilization increasing over time, particularly among adolescents. Impella was used exclusively in children >6 years, with highest use in those >11 years. All MCS types were more common in older children. Impella recipients had higher BMI, creatinine, inotrope use, and pulmonary pressures (p<0.001). Unadjusted analysis showed worse 1-year survival with ECMO and durable VAD, but not with Impella. In multivariable analysis, ECMO, congenital heart disease, dialysis use, stroke and pacemaker outcomes were independently associated with reduced 1-year survival. Impella was not associated with increased mortality. Kaplan-Meier analysis showed no significant difference in 5-year survival across MCS groups (Figure 1).
Conclusions:
MCS use has increased overtime, especially among older pediatric transplant candidates. Among MCS types, only ECMO was independently associated with reduced 1-year survival. Despite being used in higher-risk patients, Impella was not linked to adverse post-transplant outcomes.
Back to 2025 Abstracts
