Abstract
Association of Pre Transplant Functional Status at Transplant and Insurance Type in Pediatric Heart Transplantation
The Journal of heart and lung transplantation, v 45(5), pp 692-692
Apr 2026
Abstract
Purpose: Functional status predicts pediatric heart transplant outcomes, yet the impact of insurance type on this relationship remains unclear. We examined associations between functional status and early post-transplant outcomes by insurance type.
Methods: Pediatric heart transplant recipients in the UNOS database (1/2000-6/2025) were analyzed. Functional status was categorized by Lansky Play Performance Scale (LPPS): 10-40 (severe), 50-70 (moderate), or 80-100 (mild/normal). Recipient characteristics and perioperative outcomes were compared across LPPS groups, stratified by insurance (public vs private).
Results: Among 2,294 recipients, 710 had LPPS score of 10-40, 774 had LPPS 50-70, and 810 had LPPS 80-100; of these, 454 (63.9%), 455 (58.8%), and 475 (58.6%) had public insurance. Across both groups, lower functional status was associated with greater pretransplant acuity, including higher use of life support (ventilator, ECMO, IV inotropes, LVAD; all p<0.001) and ICU admission (p<0.001). Similarly, length of stay to discharge post-transplant was significantly higher for those with lower LPPS scores across insurance groups (p<0.001). For public insurance only, lower LPPS score was associated with higher rates of post-transplant dialysis (p=0.013) and stroke p=0.012) (Table 1). There was no significant difference in 6-month mortality between LPPS status groups for either privately or publicly insured recipients (Table 1).Lower functional status at transplant was linked to greater pretransplant acuity, higher life
Conclusion: Lower functional status at transplant was linked to greater pretransplant acuity, higher life support use, and longer post-transplant hospitalization across both insurance groups. Among publicly insured recipients, trends toward increased dialysis and stroke merit further study, suggesting potential disparities in postoperative complications.
Metrics
1 Record Views
Details
- Title
- Association of Pre Transplant Functional Status at Transplant and Insurance Type in Pediatric Heart Transplantation
- Creators
- S. McKay - University of California, Los AngelesM. Husain - University of California, Los AngelesJ.P. Joshi - University of California, Los AngelesN.A. Tan - University of California, Los AngelesJ. Song - University of California, Los AngelesH. Zappacosta - University of California, Los AngelesP. Cho - Drexel UniversityJ. White - University of California, Los AngelesM. Daniel - University of California, Los AngelesD. Telesca - University of California, Los AngelesA. Abramov - University of California, Los AngelesA. Ardehali - University of California, Los Angeles
- Publication Details
- The Journal of heart and lung transplantation, v 45(5), pp 692-692
- Conference
- 46th Annual Meeting and Scientific Sessions of the International Society for Heart and Lung Transplantation (ISHLT), 46th (Toronto, Ontario, Canada, 22 Apr 2026–26 Apr 2026)
- Publisher
- Elsevier
- Number of pages
- 1
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001761683000027
- Other Identifier
- 991022189369404721