Faculty Collaboration Database

Organizational structure and processes in pediatric heart transplantation: a survey of practices. Pediatr Transplant 2012 May;16(3):257-64

Date

01/17/2012

Pubmed ID

22244347

DOI

10.1111/j.1399-3046.2011.01636.x

Scopus ID

2-s2.0-84859732095 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

Despite emerging literature on pediatric heart transplantation, there continues to be variation in current practices. The degree of variability among heart transplant programs has not been previously characterized. The purpose of this study was to evaluate organizational structure and practices of pediatric heart transplant programs. The UNOS database was queried to identify institutions according to volume. Coordinators from 50 institutions were invited to participate with a 70% response rate. Centers were grouped by volume into four categories. Some institutional practices were dominated by clear volume trends. Ninety-five percent of larger centers routinely transplant patients with known antibody sensitization and report a broader range and acuity of recipients. Ninety-four percent report problems with non-adherence. Sixty-nine percent of centers routinely require prospective crossmatches. There was dramatic variation in the use of steroids across all centers. Sixty-five percent of centers transition adolescents to an adult program. Prophylaxis protocols were also highly inconsistent. This survey provided a comprehensive insight into current practices at pediatric heart transplant programs. The results delineated remarkably variable strategies for routine aspects of care. Analysis of divergence along with uniformity across protocols is a valuable exercise and may serve as a stepping-stone toward ongoing cooperation and clarity for evidence-based practice protocols.

Author List

Stendahl G, Bobay K, Berger S, Zangwill S

Author

Kathleen Bobay PhD Associate Professor in the Nursing department at Marquette University

MESH terms used to index this publication - Major topics in bold

Adolescent
Cardiology
Child
Databases, Factual
Evidence-Based Medicine
Health Knowledge, Attitudes, Practice
Heart Transplantation
Humans
Internet
Models, Organizational
Pediatrics
Reproducibility of Results
Surveys and Questionnaires