Quality care close to home: Objectives and early outcomes of a second paediatric heart transplant service in Australia.

Basu, S; Irving, C; Roberts, P; Orr, Y; Reilly, C; Casey, C; Griffiths, A; Oake, D; McElduff, M; Macdonald, P; Nair, P; Jansz, P; Festa, M

Quality care close to home: Objectives and early outcomes of a second paediatric heart transplant service in Australia.

Basu, S Irving, C Roberts, P Orr, Y Reilly, C Casey, C Griffiths, A Oake, D McElduff, M Macdonald, P

Nair, P Jansz, P Festa, M

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: J Paediatr Child Health, 2023, 59, (8), pp. 937-942
Issue Date:: 2023-08

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Field	Value	Language
dc.contributor.author	Basu, S
dc.contributor.author	Irving, C
dc.contributor.author	Roberts, P
dc.contributor.author	Orr, Y
dc.contributor.author	Reilly, C
dc.contributor.author	Casey, C
dc.contributor.author	Griffiths, A
dc.contributor.author	Oake, D
dc.contributor.author	McElduff, M
dc.contributor.author	Macdonald, P https://orcid.org/0000-0001-5378-2825
dc.contributor.author	Nair, P
dc.contributor.author	Jansz, P
dc.contributor.author	Festa, M
dc.date.accessioned	2024-04-09T22:37:56Z
dc.date.available	2023-04-18
dc.date.available	2024-04-09T22:37:56Z
dc.date.issued	2023-08
dc.identifier.citation	J Paediatr Child Health, 2023, 59, (8), pp. 937-942
dc.identifier.issn	1034-4810
dc.identifier.issn	1440-1754
dc.identifier.uri	http://hdl.handle.net/10453/177630
dc.description.abstract	AIM: We describe the experience of a new paediatric heart transplant (HT) centre in Australia. New South Wales offers quaternary paediatric cardiac services including comprehensive care pre- and post-HT; however, perioperative HT care has previously occurred at the national paediatric centre or in adult centres. Internationally, perioperative HT care is highly protocol-driven and a majority of HT occurs in low volume centres. Establishing a low volume paediatric HT centre in New South Wales offers potential for quality HT care close to home. METHODS: Retrospective review of programme data for the first 12 months was undertaken. Patient selection was audited against the programme's intended initiation criteria. Longitudinal patient data on outcomes and complications were obtained from patient medical records. RESULTS: The programme's initial phase offered HT to children with non-congenital heart disease and no requirement for durable mechanical circulatory support. Eight patients met criteria for HT referral. Three underwent interstate transfer to the national paediatric centre. Five children (13-15 years, weight 36-85 kg) underwent HT in the new programme. Individual predicted 90-day mortality was 1.3-11.6%, with increased risk for recipients transplanted from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and with restrictive/hypertrophic cardiomyopathies. Survival at 90 days and for duration of follow-up is 100%. Observed programme benefits include mitigation of family dislocation and improved continuity of care within a family-centred programme. CONCLUSION: Audit of the first 12 months' activity of a second paediatric HT centre in Australia demonstrates adherence to proposed patient selection criteria and excellent 90-day patient outcomes. The programme demonstrates feasibility of care close to home, providing continuity for all patients including those requiring increased rehabilitation and psychosocial support post-transplantation.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	J Paediatr Child Health
dc.relation.isbasedon	10.1111/jpc.16419
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Pediatrics
dc.subject.classification	3213 Paediatrics
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Child
dc.subject.mesh	Heart Transplantation
dc.subject.mesh	Australia
dc.subject.mesh	Extracorporeal Membrane Oxygenation
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	New South Wales
dc.subject.mesh	Humans
dc.subject.mesh	Extracorporeal Membrane Oxygenation
dc.subject.mesh	Heart Transplantation
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Adult
dc.subject.mesh	Child
dc.subject.mesh	Australia
dc.subject.mesh	New South Wales
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Child
dc.subject.mesh	Heart Transplantation
dc.subject.mesh	Australia
dc.subject.mesh	Extracorporeal Membrane Oxygenation
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	New South Wales
dc.title	Quality care close to home: Objectives and early outcomes of a second paediatric heart transplant service in Australia.
dc.type	Journal Article
utslib.citation.volume	59
utslib.location.activity	Australia
utslib.for	1103 Clinical Sciences
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
dc.date.updated	2024-04-09T22:37:54Z
pubs.issue	8
pubs.publication-status	Published
pubs.volume	59
utslib.citation.issue	8

Abstract:

AIM: We describe the experience of a new paediatric heart transplant (HT) centre in Australia. New South Wales offers quaternary paediatric cardiac services including comprehensive care pre- and post-HT; however, perioperative HT care has previously occurred at the national paediatric centre or in adult centres. Internationally, perioperative HT care is highly protocol-driven and a majority of HT occurs in low volume centres. Establishing a low volume paediatric HT centre in New South Wales offers potential for quality HT care close to home. METHODS: Retrospective review of programme data for the first 12 months was undertaken. Patient selection was audited against the programme's intended initiation criteria. Longitudinal patient data on outcomes and complications were obtained from patient medical records. RESULTS: The programme's initial phase offered HT to children with non-congenital heart disease and no requirement for durable mechanical circulatory support. Eight patients met criteria for HT referral. Three underwent interstate transfer to the national paediatric centre. Five children (13-15 years, weight 36-85 kg) underwent HT in the new programme. Individual predicted 90-day mortality was 1.3-11.6%, with increased risk for recipients transplanted from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and with restrictive/hypertrophic cardiomyopathies. Survival at 90 days and for duration of follow-up is 100%. Observed programme benefits include mitigation of family dislocation and improved continuity of care within a family-centred programme. CONCLUSION: Audit of the first 12 months' activity of a second paediatric HT centre in Australia demonstrates adherence to proposed patient selection criteria and excellent 90-day patient outcomes. The programme demonstrates feasibility of care close to home, providing continuity for all patients including those requiring increased rehabilitation and psychosocial support post-transplantation.

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http://hdl.handle.net/10453/177630