Publications by authors named "Gary Piercey"
Background: The sickest children among those listed for heart transplant (HT) are also at higher risk of post-transplant mortality. We hypothesized that transplant benefit, defined as percentage reduction in risk of 1-year mortality on receiving HT, increases with higher risk of wait-list mortality.
Methods And Results: We analyzed all children aged <18 years listed for first HT in the United States between July 2004 and December 2010.
Background: Previous studies have reported worse outcomes in children with nondilated cardiomyopathy (CMP) listed for heart transplant compared with children with dilated CMP. We sought to compare wait-list and posttransplant outcomes in these groups in the current era.
Methods And Results: We analyzed all children <18 years of age with a diagnosis of CMP listed for heart transplant in the United States between July 2004 and December 2010.
Background: Risk factors for early mortality after heart transplant (HT) have not been used for quantitative risk prediction. We sought to develop and validate a risk prediction model for posttransplant in-hospital mortality in HT recipients.
Methods And Results: We derived the model in subjects aged ≥18 years who underwent primary HT in the United States from January 2007 to June 2009 (n=4248) and validated it internally using a bootstrapping technique (200 random samples, n=4248).
Background: Previous studies have found no association between graft ischemic time (IT) and survival in pediatric heart transplant (HTx) recipients. However, previous studies were small or analyzed risk only at the extremes of IT, where observations are few. We sought to determine whether graft IT is independently associated with graft survival in a large cohort of children with no a priori assumptions about where the risk threshold may lie.
View Article and Find Full Text PDFBackground: Extracorporeal membrane oxygenation (ECMO) has served for >2 decades as the standard of care for US children requiring mechanical support as a bridge to heart transplantation. Objective data on the safety and efficacy of ECMO for this indication are limited. We describe the outcomes of ECMO as a bridge to heart transplantation to serve as performance benchmarks for emerging miniaturized assist devices intended to replace ECMO.
View Article and Find Full Text PDFObjective: Infants undergoing heart transplantation have the highest early posttransplant mortality of any age group. We sought to determine the pretransplantation factors associated with in-hospital mortality in transplanted infants in the current era.
Methods: All infants under 12 months of age who underwent primary heart transplantation during a recent 10-year period (1999-2009) in the United States were identified using the Organ Procurement and Transplant Network database.
Background: Posttransplant survival in heart transplant recipients has progressively improved during the past 2 decades. It is unknown, however, whether the major racial groups in the United States have benefited equally.
Methods And Results: We analyzed all primary heart transplant recipients aged ≥18 years in the United States from 1987 to 2008.
Background: Uncertainty exists whether hearts from infants who have died of sudden infant death syndrome (SIDS) are acceptable for transplantation because the mechanism of death in SIDS remains unclear. We analyzed post-transplant outcomes in infants who received a heart from a donor where SIDS was the primary cause of brain death.
Methods: This retrospective multicenter cohort study used data from the Organ Procurement and Transplant Network (OPTN).
Background: The purported advantage of ABO-incompatible (ABO-I) listing is to reduce wait times and wait-list mortality among infants awaiting heart transplantation. We sought to describe recent trends in ABO-I listing for US infants and to determine the impact of ABO-I listing on wait times and wait-list mortality.
Methods And Results: In this multicenter retrospective cohort study using Organ Procurement and Transplant Network data, infants<12 months of age listed for heart transplantation between 1999 and 2008 (n=1331) were analyzed.
Background: Infants awaiting heart transplantation (HT) face the highest wait-list mortality among all children and adults listed for HT in the USA. We sought to determine the risk of death for infants <12 months old while awaiting HT in the current era, and to identify the principle risk factors associated with wait-list mortality.
Methods: We analyzed outcomes for all infants listed for HT in the USA from January 1999 to July 2006, using data reported to the U.
Background: Children listed for heart transplantation face the highest waiting list mortality in solid-organ transplantation medicine. We examined waiting list mortality since the pediatric heart allocation system was revised in 1999 to determine whether the revised allocation system is prioritizing patients optimally and to identify specific high-risk populations that may benefit from emerging pediatric cardiac assist devices.
Methods And Results: We conducted a multicenter cohort study using the US Scientific Registry of Transplant Recipients.
Objective: Anomalous origin of 1 of the branch pulmonary arteries from the aorta with 2 normal semilunar valves (hemitruncus) is a rare entity. There have been several small case series reported. We report here our single-institution surgical experience with hemitruncus from 1982 to 2006.
View Article and Find Full Text PDFObjectives: This study sought to review the outcomes of 3 generations of closure devices for secundum atrial septal defects (ASDs) at a single institution.
Background: Transcatheter closure of ASDs is now increasingly performed with devices that have been modified over time to improve performance.
Methods: A review of prospective clinical trials of Clamshell (C.