Publications

Outcomes of ventricular assist device placement in pediatric patients with renal dysfunction requiring dialysis: an ACTION registry analysis

Summary

Outcomes for renal replacement therapy in pediatric VAD patients have not been well described, even though adults who need it tend to do poorly after VAD implantation.

Researchers drew on the ACTION registry, which spans 57 North American sites, and included 1,607 children who received a VAD between April 2018 and June 2025. They compared the 75 children, 4.7% of the cohort, who were on renal replacement therapy at the time of surgery, whether long-term dialysis or newly started therapy, with those who were not.

Children on renal replacement therapy were in worse condition before implant, with more ECMO support, higher INTERMACS classifications, and higher bilirubin. They were less likely to reach heart transplant (44.0% versus 61.4%) and had lower one-year survival (58.4% versus 78.3%).

However, once the analysis accounted for other factors, renal replacement therapy was not independently associated with one-year mortality.

The authors conclude that this group is rare, and suggest that the severity of the children’s underlying illness drives their outcomes.

This ACTION study was published on September 17, 2026 online in The Annals of Thoracic Surgery.  Congratulations to the authors:

  • Michael A. Catalano, MD
  • Jonathan B. Edelson, MD, MSCE
  • Shahnawaz Amdani, MD
  • Muhammad F. Shezad, MS
  • Angela Lorts, MD, MBA
  • David N. Rosenthal, MD
  • Halil Beqaj, MD, MS
  • David M. Peng, MD
  • Scott Auerbach, MD
  • Jennifer Su, MD
  • Lawrence Greiten, MD
  • Ryan Butts, MD
  • Arene Butto, MD
  • Daphne Hsu, MD
  • Katsuhide Maeda, MD, PhD
CITATION

Catalano M, Edelson J, Amdani S, et al., Outcomes of ventricular assist device placement in pediatric patients with renal dysfunction requiring dialysis: an ACTION registry analysis, The Annals of Thoracic Surgery, 2026; 0. DOI: 10.1016/j.athoracsur.2026.09.014
ACTION Publications