Abstract
ABSTRACT
Background
Heart transplantation is definitive therapy for children with end‐stage heart failure. Because donor availability is unpredictable, transplantation occurs overnight or on weekends. Although studies report mixed findings on the association between operative timing and outcomes, pediatric data remain limited. We evaluated the impact of operative timing on pediatric heart transplant outcomes.
Methods
We studied pediatric heart transplant recipients (
Results
Among 6125 recipients, 2930 (47.8%) transplants occurred during the day and 3195 (52.2%) at night; 4408 (72.0%) occurred on weekdays and 1717 (28.0%) on weekends. Kaplan–Meier analysis demonstrated no significant survival difference between daytime and nighttime transplants (
p
= 0.266) or weekday and weekend transplants (
p
= 0.210). In multivariable Cox regression, operative timing was not associated with mortality (night vs. day: hazard ratio 0.97, 95% confidence interval 0.89–1.06,
p
= 0.554; weekend versus weekday: hazard ratio 1.04, 95% confidence interval 0.94–1.15,
p
= 0.445). Acute rejection prior to discharge and treatment for rejection within 1 year was more frequent in daytime transplants without affecting graft survival.
Conclusions
Operative timing was not associated with patient survival, graft survival, or postoperative outcomes after pediatric heart transplantation.