Mortality rates for children awaiting heart transplants have significantly decreased over the past two decades, with a 38% reduction in wait-list mortality from 1999 to 2023. However, one in eight children still die while on the transplant list, highlighting the need for better allocation systems. The current three-tier system used for pediatric heart transplants, last updated in 2016, may not adequately prioritize patients based on medical urgency. Researchers suggest that a new allocation system based on a multimodal score could more effectively stratify risk and improve survival outcomes, as evidenced by similar changes made for adult heart transplants.

The study found that improvements in pediatric heart transplant care, such as increased use of ventricular assist devices (VADs) and ABO-incompatible transplants, have contributed to better outcomes. Mortality rates among nonwhite candidates and children with blood group O have decreased, and racial disparities are narrowing. Despite these advancements, researchers argue that a continuous risk score, which factors in both pre- and posttransplant survival, could more accurately rank children on the waitlist and prevent further deaths.

Reference: Maxwell Y. Fewer Kids Now Die While Awaiting Heart Transplant, but There’s Room for Improvement. TCTMD. Published August 5, 2024. Accessed September 12, 2024. https://www.tctmd.com/news/fewer-kids-now-die-while-awaiting-heart-transplant-theres-room-improvement