59-Early Cardiac Complications After Pediatric Hematopoietic Stem Cell Transplant
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Pediatrics, Transplant, 2021
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The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

Diana Belen Bermudez 


Introduction/Hypothesis: Chemotherapy and radiation regimens used for Hematopoietic stem cell transplant (HSCT) are known to have severe cardiotoxic effects. However, research in pediatrics evaluating the incidence of early cardiac complications after HSCT is lacking. The objective of this study is to assess the incidence of cardiac complications and mortality associated with pediatric HSCT.

Methods: A retrospective analysis of the Healthcare Cost and Utilization Project 2016 Kids Inpatient Database was performed. The database was filtered using ICD-10 procedure codes for HSCT for patients between 28 days and 20 years of age and evaluated the presence of the following cardiac complications including: congestive heart failure, pericardial effusion, cardiac tamponade, myocardial infarction, arrhythmias, cardiomyopathy, myocarditis, endocarditis, intracardiac thrombosis. Basic demographic data was obtained, and statistical analysis using chi-squared was performed on SPSS.

Results: A population of 2,275 patients with HSCT was included. The median age was 7 (IQR 2-13) years. Cardiac complications were found in 6.8% of patients (OR 5.7, CI 4.8 - 6.7), of which prolonged QT interval was the most common diagnosis (2.3%), followed by pericardial effusion (2.2%) and cardiomyopathy (1.2%). Cardiac complications were more common in children with leukemia than in those without leukemia, (11.7% vs 4.9%; OR:2.5, CI 1.8 – 3.6). Acute myeloid leukemia (AML) was more likely to have cardiac complications than patients with acute lymphoblastic leukemia (ALL), (16.6% vs. 10.4%; OR: 3.1 vs OR: 1.6, P < 0.05). Moreover, cardiac complications occurred more frequently after allogenic HSCT than after autologous HSCT, (9.2% vs 4.0%; OR: 2.5, CI: 1.7 – 3.6). The overall mortality in HSCT patients was 4.4%. The mortality in HSCT patients with cardiac complications was 15.5% and without cardiac complications was 3.5% (OR 4.9, CI 3.0 – 8.1).

Conclusions: Our study provides national data on the early cardiac complications and mortality after pediatric HSCT. The incidence of cardiac complications is 6.8%. The overall mortality rate is 4.4% and is higher if a cardiac condition was found. Cardiac complications are more common in children with leukemia, especially with AML, and in children after allogenic compared to autologous HSCT.


Meta Tag
Content Type Presentation
Knowledge Area Pediatrics
Knowledge Area Transplant
Knowledge Level Advanced
Membership Level Select
Tag Stem Cells
Tag Transplant
Year 2021
Diana Belen-Bermudez
cardiac complications
pediatric hematopoietic stem cell transplant


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