Meghna D Patel, MD, Daniel Bernstein, MD, Gregory Hammer, MD

Immunologic Profiling Correlated to Outcomes in Pediatric Heart Failure Patients After Left Ventricular Assist Device Placement
Stanford University, Palo Alto, CA
Meghna D Patel, MD, Daniel Bernstein, MD, Gregory Hammer, MD – $50,000

Heart failure in children is a diverse disease associated with significant morbidity and mortality, that differs from adult heart failure. An increasing number of pediatric patients with heart failure are supported with ventricular assist devices (VADs) as a bridge to transplantation, or occasionally used as destination therapy to achieve improved quality of life when the disease is terminal. These pediatric patients are at a high risk of infection, stroke, device thrombosis, bleeding, and even death related to body’s reaction to the device. Unfortunately, the specific risk factors for these complications are unknown. Profiling the individual human immune system has been shown to correlate with clinical outcomes in other groups of high-risk patients such as those hospitalized after orthopedic surgery as well as to stratify elderly individuals’ risk of mortality. The purpose of our study is to evaluate blood immunologic markers in order to (1) identify differences in the degree of inflammation within the pediatric VAD population, and (2) to correlate these patterns of inflammation with clinical outcomes. Novel technology with CyTOF (mass cytometry) will provide a more comprehensive and in-depth evaluation of the immune system in this patient population. The study will aim to show that unique patterns of inflammatory markers can identify patients at higher risk of complications, which would allow earlier recognition, intervention, and ultimately improved outcomes.