{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T12:05:24Z","timestamp":1779365124930,"version":"3.53.0"},"reference-count":0,"publisher":"George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Crit Care Med (Targu Mures)"],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:p>Background:\nPediatric heart transplantation stays the gold standard treatment for end-stage heart failure, but outcomes are influenced by pre-transplant status and bridging strategies, particularly mechanical circulatory support (MCS).\nObjectives:\nTo evaluate early outcomes following pediatric heart transplantation and assess the impact of pre-transplant MCS on survival and complications.\nMethods:\nWe retrospectively analyzed all pediatric patients ( 14 years) who underwent orthotopic heart transplantation at a single tertiary center between January 2020 and January 2025. Demographics, pre-transplant support, intraoperative data, and early outcomes were collected. Primary outcome was 30-day survival; secondary outcomes included acute rejection, infection, acute kidney injury (AKI), neurologic complications, and ICU\/hospital length of stay (LOS). Comparative analyses were performed between patients having ECMO- and ventricular assist devises (VAD) using Fisher\u2019s exact and Wilcoxon rank-sum tests. Kaplan\u2013Meier survival estimates were generated.\nResults:\nThirty patients were transplanted (median age 9 years, 63.3% female). Most (96.7%) needed MCS, including 11 ECMO and 18 VAD. Thirty-day survival was 28\/30 (93.5%, 95% CI 78\u201399). Acute rejection occurred in 3 (10%), infections in 4 (13.3%), AKI in 8 (26.7%), with two requiring CRRT, and neurologic complications in 3 (10.3%). Median ICU and hospital LOS were 20 and 37 days, respectively. ECMO patients had longer post-transplant ventilation (12 vs 6 days, p = 0.04) and ICU length of stay (LOS) compared to VAD patients. Total Ischemic time, and CPB times were associated with increased morbidity.\nConclusions:\nEarly outcomes after pediatric heart transplantation prove high short-term survival but substantial morbidity. ECMO bridging was associated with greater resource use than VAD. Improving donor heart ischemic time, donor-recipient matching, perioperative management, and early initiation of durable MCS may further improve outcomes.<\/jats:p>","DOI":"10.62838\/jccm-2026-0016","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:06:20Z","timestamp":1779361580000},"page":"291-299","source":"Crossref","is-referenced-by-count":0,"title":["Early Outcomes of Pediatric Heart Transplantation: Impact of Mechanical Circulatory Support and Perioperative Challenges. A Single-Center Retrospective Study"],"prefix":"10.62838","volume":"12","author":[{"name":"king faisal specialist hospital and research center riyadh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Shahzad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Beheri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"King Faisal Specialist Hospital and Research Center Riyadh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bushra","family":"Algethami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"King Faisal Specialist Hospital and Research Center Riyadh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Alheraish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"King Faisal Specialist Hospital and Research Center Riyadh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimpna","family":"Albert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"King Faisal Specialist Hospital and Research Center Riyadh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"King Faisal Specialist Hospital and Research Center Riyadh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohair","family":"Alhalees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"King Faisal Specialist Hospital and Research Center Riyadh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Alarwan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"King Faisal Specialist Hospital and Research Center Riyadh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"49540","published-online":{"date-parts":[[2026,4,30]]},"container-title":["Journal of Critical Care Medicine"],"original-title":[],"link":[{"URL":"https:\/\/ojs.jccm.ro\/index.php\/jccm\/article\/view\/23\/9","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:06:27Z","timestamp":1779361587000},"score":1,"resource":{"primary":{"URL":"https:\/\/ojs.jccm.ro\/index.php\/jccm\/article\/view\/23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,30]]},"published-print":{"date-parts":[[2026,4,30]]}},"URL":"https:\/\/doi.org\/10.62838\/jccm-2026-0016","relation":{},"ISSN":["2393-1809","2393-1817"],"issn-type":[{"value":"2393-1809","type":"print"},{"value":"2393-1817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}