Outcomes of fetal listed patients awaiting heart transplantation

Pediatr Transplant. 2013 Nov;17(7):653-60. doi: 10.1111/petr.12130. Epub 2013 Aug 6.


HTx in neonates is mainstay therapy for those with severe cardiomyopathies and congenital heart disease. Fetal listing for HTx has been proposed as a way to increase the potential window for a donor with outcomes predicted to be similar to the neonatal population. Data from the PHTS, a prospective multicenter study, were used to examine the outcomes of fetuses listed between 1993 and 2009. Four thousand three hundred and sixty-five children were listed for HTx during this period. Fetuses comprised 1% and neonates 19.8% of listed patients. In those patients listed as fetus and transplanted, the median wait time from listing to HTx was 55 days (range 4-255), with a median of 25 days (range 0-233) after birth. By six months post-listing, a higher proportion of fetal listed patients had undergone HTx with a lower waitlist mortality when compared with neonate. There was no significant difference in survival following HTx between the two group (p = 0.4). While the results of this study may be less applicable to current practice due to changes in referrals for fetal listing, they do indicate that fetal listing can be a reasonable option. These results are of particular interest at the present time given the ongoing public discourse on the proposed elimination of fetal listing within UNOS.

Keywords: fetus; infant; pediatric heart transplant; transplant listing.

Publication types

  • Multicenter Study

MeSH terms

  • Age Factors
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / surgery*
  • Databases, Factual
  • Female
  • Fetal Heart
  • Heart Defects, Congenital / diagnosis
  • Heart Defects, Congenital / surgery*
  • Heart Transplantation*
  • Humans
  • Infant, Newborn
  • Male
  • Pregnancy
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Waiting Lists*