Resource utilization of cytomegalovirus immune globulin in prevention and treatment of cytomegalovirus infection in pediatric heart transplantation

2019 ◽  
Vol 33 (12) ◽  
Author(s):  
Alfred Asante‐Korang ◽  
Jennifer Carapellucci ◽  
Diane Krasnopero ◽  
Brian Brown ◽  
Amy Kiskaddon ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Resource Utilization ◽  
Immune Globulin ◽  
Cytomegalovirus Infection ◽  
Prevention And Treatment ◽  
Pediatric Heart Transplantation

Resource Utilization for Initial Hospitalization in Pediatric Heart Transplantation in the United States

2018 ◽  
Vol 121 (8) ◽  
pp. 981-985 ◽  
Author(s):  
Dana M. Boucek ◽  
Ashwin K. Lal ◽  
Aaron W. Eckhauser ◽  
Hsin-Yi Cindy Weng ◽  
Xiaoming Sheng ◽  
...  
Keyword(s):  
United States ◽  
Heart Transplantation ◽  
Resource Utilization ◽  
The United States ◽  
Pediatric Heart Transplantation ◽  
Initial Hospitalization

Charges and resource utilization for pediatric heart transplantation across a positive virtual and/or cytotoxicity crossmatch

2017 ◽  
Vol 22 (1) ◽  
pp. e13095 ◽  
Author(s):  
Shawn C. West ◽  
Steven A. Webber ◽  
Adriana Zeevi ◽  
Susan A. Miller ◽  
Victor O. Morell ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Resource Utilization ◽  
Pediatric Heart Transplantation

Abstract 18039: Resource Utilization for Initial Hospitalization in Pediatric Heart Transplantation in the United States

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Dana M Boucek ◽  
Ashwin K Lal ◽  
Nelangi M Pinto ◽  
Hsin-Yi Cindy Weng ◽  
Jacob F Wilkes ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Resource Utilization ◽  
Resource Use ◽  
The United States ◽  
Total Charge ◽  
Factors Associated ◽  
Center Volume ◽  
Event Driven ◽  
Pediatric Heart Transplantation ◽  
Initial Hospitalization

Background: Pediatric heart transplantation (HT) is resource intensive. Event driven pediatric HT databases do not capture data on resource use. The objective of this study was to evaluate resource utilization and identify associated factors during initial hospitalization for pediatric HT in a large multi-institutional cohort. Methods: This is a multicenter retrospective cohort study using the PHIS database (43 US children’s hospitals) of children ≤ 19 years of age who underwent HT between 1/07 and 7/13. Data collected: Demographic variables including site, payer, distance and time to center, clinical pre and post-transplant variables, mortality, cost and charge. Total length of stay (LOS) and charge for initial hospitalization were used as surrogates for resource use. Charges were inflation adjusted to 2013 $. Gamma regression analysis was performed to evaluate factors associated with resource use. Results: Of 1629 subjects, 54% were male, and the median age at HT was 5 years (IQR 0-13). The median total and ICU LOS were 51 (IQR: 23-98) and 23 (IQR: 9-58) days respectively, and mortality occurred in 82 (5%). Total charge and cost for hospitalization were $852,713 ($464,900-$1,609,300) and $383,600 ($214,900-$681,000) respectively. Factors associated with resource use on multivariate analysis are shown in Table 1. Younger age, lower center volume, southern region, and comorbidities prior to HT were associated with higher resource use. In later years, costs increased despite shorter LOS. Conclusions: This large multicenter study provides novel insight into factors associated with resource use in pediatric HT that cannot be assessed in alternative event driven transplant databases. Peri-transplant morbidities are associated with increased cost and LOS. Reducing costs in line with LOS will improve health care value. Regional and center volume differences need further investigation for optimizing value-based care and efficient use of scarce resources.

Neuropsychological Functioning After Pediatric Heart Transplantation

2010 ◽  
Author(s):  
Kelly L. Konopacki ◽  
Jennifer L. Bruno ◽  
Amy M. Wisniewski ◽  
Shelli R. Kesler ◽  
David N. Rosenthal ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Neuropsychological Functioning ◽  
Pediatric Heart Transplantation

scholarly journals Post-transplant absolute lymphocyte count predicts early cytomegalovirus infection after heart transplantation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Minjae Yoon ◽  
Jaewon Oh ◽  
Kyeong-Hyeon Chun ◽  
Chan Joo Lee ◽  
Seok-Min Kang
Keyword(s):  
High Risk ◽  
Heart Transplantation ◽  
Immunosuppressive Therapy ◽  
Lymphocyte Count ◽  
Cytomegalovirus Infection ◽  
Absolute Lymphocyte Count ◽  
Cmv Infection ◽  
Igg Antibody ◽  
Post Transplant ◽  
The Relationship

AbstractImmunosuppressive therapy can decrease rejection episodes and increase the risk of severe and fatal infections in heart transplantation (HT) recipients. Immunosuppressive therapy can also decrease the absolute lymphocyte count (ALC), but the relationship between early post-transplant ALC and early cytomegalovirus (CMV) infection is largely unknown, especially in HT. We retrospectively analyzed 58 HT recipients who tested positive for CMV IgG antibody and received basiliximab induction therapy. We collected preoperative and 2-month postoperative data on ALC and CMV load. The CMV load > 1200 IU/mL was used as the cutoff value to define early CMV infection. Post-transplant lymphopenia was defined as an ALC of < 500 cells/μL at postoperative day (POD) #7. On POD #7, 29 (50.0%) patients had post-transplant lymphopenia and 29 (50.0%) patients did not. The incidence of CMV infection within 1 or 2 months of HT was higher in the post-transplant lymphopenia group than in the non-lymphopenia group (82.8% vs. 48.3%, P = 0.013; 89.7% vs. 65.5%, P = 0.028, respectively). ALC < 500 cells/μL on POD #7 was an independent risk factor for early CMV infection within 1 month of HT (odds ratio, 4.14; 95% confidence interval, 1.16–14.77; P = 0.029). A low ALC after HT was associated with a high risk of early CMV infection. Post-transplant ALC monitoring is simple and inexpensive and can help identify patients at high risk of early CMV infection.

Health‐related quality of life after pediatric heart transplantation in early childhood

2020 ◽  
Vol 24 (7) ◽  
Author(s):  
Gonzalo Garcia Guerra ◽  
Gwen Y. Bond ◽  
Ari R. Joffe ◽  
Irina A Dinu ◽  
Morteza Hajihosseini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Early Childhood ◽  
Heart Transplantation ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Pediatric Heart Transplantation
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