Clinical approach to vasoplegia in the transplant patient from the Pediatric Heart Transplant Society

Shriprasad R Desphpande; David W Bearl; Pirooz Eghtesady; Heather T Henderson; Scott Auerbach; Aamir Jeewa; Neha Bansal; Shahnawaz Amdani; Marc E Richmond; Loren D Sacks; Renata Shih; Madeleine Townsend; Jennifer Conway

doi:10.1111/petr.14392

Clinical approach to vasoplegia in the transplant patient from the Pediatric Heart Transplant Society

Pediatr Transplant. 2022 Dec;26(8):e14392. doi: 10.1111/petr.14392.

Authors

Affiliations

¹ Department of Cardiology and Cardiovascular Surgery, Children's National Hospital, The George Washington University, Washington, DC, USA.
² Department of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, Tennessee, USA.
³ Section of Pediatric Cardiothoracic Surgery, St Louis Children's Hospital and School of Medicine, Washington University, St Louis, Michigan, USA.
⁴ Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA.
⁵ Pediatrics, Division of Cardiology, University of Colorado, Denver Anschutz Medical Campus, Children's Hospital Colorado Aurora, Aurora, Colorado, USA.
⁶ Department of Cardiology, Hospital for Sick Children, Toronto, Ontario, Canada.
⁷ Children's Hospital at Montefiore, Bronx, New York, USA.
⁸ Cleveland Clinic Children's, Cleveland, Ohio, USA.
⁹ Division of Pediatric Cardiology, Department of Pediatrics, Columbia University College of Physician and Surgeons, Morgan Stanley Children's Hospital, New York, New York, USA.
¹⁰ Pediatric Cardiology, Stanford University School of Medicine, Palo Alto, California, USA.
¹¹ Congenital Heart Center, Division of Pediatric Cardiology, University of Florida, Gainesville, Florida, USA.
¹² Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.

PMID: 36377326
DOI: 10.1111/petr.14392

Abstract

This manuscript outlines a clinical approach to vasoplegia incorporating the current state of knowledge regarding vasoplegia in pediatric patients immediately post-transplant and to identify modifiable factors both pre- and post-transplant that may reduce post-operative morbidity, end-organ dysfunction, and mortality. Centers participating in the Pediatric Heart Transplant Society (PHTS) were asked to provide their internal protocols and rationale for vasoplegia management, and applicable adult and pediatric data were reviewed. The authors synthesized the above protocols and literature into the following description of clinical approaches to vasoplegia highlighting areas of both broad consensus and of significant practice variation.

Keywords: pediatric heart transplant; post-operative; vasoplegia.

MeSH terms

Adult
Child
Heart Transplantation*
Humans
Retrospective Studies
Risk Factors
Vasoplegia* / etiology