The Impact of Pre-Transplant Ventricular Assist Device Support on Survival After Heart Transplantation in Pediatric Patients: A Systematic Review and Meta-Analysis of Reconstructed Time-To-Event Data.
J, F., S, S., R, P., A, A., A, A., FS, P., H, K., T, D., G, K., & T, L. (2026). The Impact of Pre-Transplant Ventricular Assist Device Support on Survival After Heart Transplantation in Pediatric Patients: A Systematic Review and Meta-Analysis of Reconstructed Time-To-Event Data.. Pediatric transplantation. https://doi.org/10.1111/petr.70356
J F, S S, R P, A A, A A, FS P, et al. The Impact of Pre-Transplant Ventricular Assist Device Support on Survival After Heart Transplantation in Pediatric Patients: A Systematic Review and Meta-Analysis of Reconstructed Time-To-Event Data.. Pediatric transplantation. 2026; doi: 10.1111/petr.70356
J F, S S, R P, et al. The Impact of Pre-Transplant Ventricular Assist Device Support on Survival After Heart Transplantation in Pediatric Patients: A Systematic Review and Meta-Analysis of Reconstructed Time-To-Event Data.[J]. Pediatric transplantation. 2026. DOI: 10.1111/petr.70356.
@article{j2026,
author = {Fischer J and Schwegmann S and Plem R and Arobo A and Almehandi A and Passos FS and Kirov H and Doesnt T and Kerst G and Loukanov T},
title = {The Impact of Pre-Transplant Ventricular Assist Device Support on Survival After Heart Transplantation in Pediatric Patients: A Systematic Review and Meta-Analysis of Reconstructed Time-To-Event Data.},
journal = {Pediatric transplantation},
year = {2026},
doi = {10.1111/petr.70356},
note = {PMID: 42210029},
}
TY - JOUR AU - Fischer J AU - Schwegmann S AU - Plem R AU - Arobo A AU - Almehandi A AU - Passos FS AU - Kirov H AU - Doesnt T AU - Kerst G AU - Loukanov T TI - The Impact of Pre-Transplant Ventricular Assist Device Support on Survival After Heart Transplantation in Pediatric Patients: A Systematic Review and Meta-Analysis of Reconstructed Time-To-Event Data. T2 - Pediatric transplantation PY - 2026 DO - 10.1111/petr.70356 AN - PMID:42210029 ER -
OBJECTIVES: Heart transplantation is the gold standard therapy for pediatric end-stage heart failure. Ventricular assist devices (VADs) have improved waitlist survival, but their effect on post-transplant outcomes remains uncertain. This study aimed to evaluate the impact of pre-transplant VAD support on outcomes in pediatric heart transplant recipients. METHODS: We performed a systematic review and a meta-analysis using three different databases to compare outcomes in pediatric heart transplant recipients with and without pre-transplant VAD support. The primary outcome was long-term survival. Secondary outcomes were postoperative stroke, hospital length of stay (LOS), and post-transplantation rejection. RESULTS: A total of 3247 studies were identified, of which five were included in the analysis. There was no significant difference in long-term survival among patients who survived to transplantation between the groups (HR 0.963; 95% CI 0.84 to 1.10; p = 0.582). However, the postoperative stroke rate was significantly higher in the VAD group (OR 2.17; 95% CI 1.63 to 2.89; p < 0.0001), while no significant differences were observed in hospital LOS (SMD -0.09; 95% CI -0.33 to 0.14; p = 0.4375) or post-transplant rejection (OR 1.18; 95% CI 1.00 to 1.39; p = 0.0505). CONCLUSIONS: Pre-transplant VAD support was associated with non-inferior survival despite greater baseline severity among patients who survived to transplantation, enabling access to transplantation, but at the cost of higher VAD-related complications, particularly stroke, with no differences in hospital LOS or rejection.