Outcomes of Pediatric Patients Bridged to Heart Transplantation from Extracorporeal Membrane Oxygenation Support
Bibliographic record
Abstract
Extracorporeal membrane oxygenation (ECMO) is used as a salvage therapy in children with irreversible myocardial failure who may be candidates for heart transplantation (HTx) (at the Hospital for Sick Children). We retrospectively assessed outcomes of children wait-listed for HTx from ECMO, and risk factors for patients (pts) bridged to HTx from January 1990 through December 2005. Of 205 patients supported with cardiac ECMO, 46 were wait-listed for HTx. Sixteen patients died before HTx: eight died while wait-listed on ECMO; eight were delisted (clinical deterioration; all died); five were delisted (improved), and 25 (54%) underwent HTx from ECMO. Of 25 patients who underwent HTx (median age 7.0 years [10 days to 17 years]), 13 had myocarditis or cardiomyopathy, and 12 had congenital heart disease. Median ECMO duration was 6.7 days (3-18 days). Median follow-up was 4.3 years (0.2-10.6 years). Four patients died <1 week post-HTx, and 21 survived until hospital discharge (84%). Post-transplant survival was 67% and 52% at 1 and 5 years, respectively. Risk factors for early death were older age, higher body surface area, higher creatinine before and during ECMO, fungal infections, and exposure to blood products. In summary, few risk factors preclude HTx candidacy from ECMO. The impact of newer assist technology on ECMO, wait-list mortality, and HTx outcomes remains to be elucidated.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".