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Complications related to the transplantation of thoracic organs: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease

Part of: The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD)

Published online by Cambridge University Press:  01 December 2008

Howard Jeffries ,
Geoff Bird ,
Yuk Law ,
Gil Wernovsky ,
Paul Weinberg ,
Christian Pizarro  and
Giovanni Stellin
Howard Jeffries*
Affiliation:
Division of Critical Care, University of Washington, Seattle Children’s Hospital, Seattle, Washington, United States of America
Geoff Bird
Affiliation:
Division of Pediatric Cardiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Pennsylvania, United States of America
Yuk Law
Affiliation:
Division of Cardiology, University of Washington, Seattle Children’s Hospital, Seattle, Washington, United States of America
Gil Wernovsky
Affiliation:
Division of Pediatric Cardiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Pennsylvania, United States of America
Paul Weinberg
Affiliation:
Division of Pediatric Cardiology, The Children’s Hospital of Philadelphia, Pennsylvania, United States of America
Christian Pizarro
Affiliation:
Cardiac Surgery, The Nemours Cardiac Center and the Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States of America
Giovanni Stellin
Affiliation:
Pediatric Cardiac Surgery Unit – University of Padova Medical School, Padova, Italy
*
Correspondence to: Howard Jeffries, MD, Critical Care, University of Washington, Seattle Children’s Hospital, Seattle, Washington, 98105, United States of America. Tel: (206) 987-2140; Fax: (206) 987-3866; E-mail: Howard.Jeffries@seattlechildrens.org
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Abstract

A complication is an event or occurrence associated with a disease or a healthcare intervention, which constitutes a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after an intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.

The Multi-Societal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to patients who have received transplantation of the heart, heart and lung(s) or lung(s). These specific definitions and terms will be used to track morbidity associated with transplantation in a common language across many separate databases.

The complications of transplantation are known risks of congenital cardiac surgery. The purpose of this effort is to propose consensus definitions for post-transplant complications following cardiac surgery so that collection of such data can be standardized. Clinicians caring for patients who have had transplantation of thoracic organs will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing treatment strategies.

Keywords

Congenital heart diseasequality improvementpatient safetyoutcomesregistryoperative morbiditypaediatricsurgerycongenital abnormalitiescardiac surgical proceduresheartheart transplantationlung transplantation
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue S2: Databases and the assessment of complications associated with the treatment of patients with congenital cardiac disease , December 2008 , pp. 265 - 270
Copyright
Copyright © Cambridge University Press 2008

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References

1.Showengertdt, KO. Advances in pediatric heart transplantation. Curr Opin Pediatr 2006; 18: 512–517.CrossRefGoogle Scholar
2.Yousem, SA, Berry, GJ, Cagle, PT, et al. Revision of the 1990 working formulation for the classification of pulmonary allograft rejection: Lung Rejection Study Group. J Heart Lung Transplant 1996; 15: 1–15.Google ScholarPubMed
3.Stewart, S, Winters, GL, Fishbein, MC, et al. Revision on the 1990 working formulation for the standardization of nomenclature in the diagnosis of heart rejection. J Heart Lung Transplant 2005; 24: 1710–1720.CrossRefGoogle ScholarPubMed
4.Christie, JD, Carby, M, Bag, R, et al. Report of the ISHLT working group on primary lung graft dysfunction Part II: Definition. A consensus statement of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2005; 24: 1454–1459.CrossRefGoogle Scholar
5.Billingham, ME. Histopathology of graft coronary disease. J Heart Lung Transplant 1992; 11: S38–S44.Google ScholarPubMed
6.Pinney, SP, Mancini, D. Cardiac allograft vasculopathy: advances in understanding its pathophysiology, prevention and treatment. Curr Opin Cardiol 2004; 19: 170–176.CrossRefGoogle ScholarPubMed
7.Caforio, AL, Tona, F, Piaserico, S, et al. Immune and nonimmune predictors of cardiac allograft vasculopahty onset and severity: multivariate risk factor analysis and role of immunosuppression. Am J Transplant 2004; 4: 962–970.CrossRefGoogle Scholar
8.Valentine, HA. Cardiac allograft vasculopathy after heart transplantation: risk factors and management. J Heart Lung Transplant 2004; 23 (5 Suppl): S187–S193.CrossRefGoogle Scholar
9.Grattan, MT, Moreno-Cabral, CE, Starnes, VA, Oyer, PE, Stinson, EB, Shumway, NE. Cytomegalovirus infection is associated with cardiac allograft rejection and atherosclerosis. JAMA 1989; 261: 3561–3566.CrossRefGoogle ScholarPubMed
10.http://biomed.brown.edu/Courses/BI108/BI108_2004_Groups/Group04/Rejection_overview.htm, accessed July, 20, 2006.Google Scholar
11.Snell, GI, Boehler, A, Glanville, AR, et al. Eleven years on: A clinical update of key areas of the 1996 lung allograft rejection working formulation. J Heart Lung Transplant 2007; 26: 423–430.CrossRefGoogle ScholarPubMed
12.http://www.emedicine.com/ped/topic2841.htm, accessed July 20, 2006.Google Scholar
13.http://path.upmc.edu/divisions/pulmpath/bron02.htm, accessed July 22, 2006.Google Scholar
14.Welke, KF, Dearani, JA, Ghanayem, NS, Beland, MJ, Shen, I, Ebels, T. Renal complications associated with congenital cardiac surgery: consensus definitions form the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease. Cardiol Young 2008; 18 (Suppl… this supplement).CrossRefGoogle Scholar
15.Magro, CM, Pope Harman, A, Klinger, D, et al. Use of C4d as a diagnostic adjunct in lung allograft biopsies. Am J Transplant 2003; 3: 1143–1154.CrossRefGoogle ScholarPubMed
16.Miller, GG, Destarac, L, Zeevi, A, et al. Acute humoral rejection of human lung allografts and elevation of C4d in bronchoalveolar lavage fluid. Am J Transplant 2004; 4: 1323–1330.CrossRefGoogle ScholarPubMed
17.Wallace, WD, Reed, EF, Ross, D, Lassman, CR, Fishbein, MC. C4d staining of pulmonary allograft biopsies: an immunoperoxidase study. J Heart Lung Transplant 2005; 24: 1565–1570.CrossRefGoogle ScholarPubMed