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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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