# Operatietijd en weekendoperaties hebben geen invloed op overleving na kinderharttransplantatie

*geplaatst 2026-10-09 · Hartfalen · Pediatric transplantation · doi 10.1111/petr.70474 · https://hartvaat.nl/2026/10/01/operatietijd-en-weekendoperaties-hebben-geen-invloed-op-overleving-na-kinderhart/*

Een analyse van 6125 kinderharttransplantaties in het UNOS-registry (2000–2018) toont aan dat de operatietijd (dag versus nacht) en de dag van de week (doordeweeks versus weekend) geen significante invloed hebben op de patiënt- of graftoverleving. Multivariabele analyse bevestigde dit (HR 0,97 voor nacht versus dag; HR 1,04 voor weekend versus doordeweeks), ondanks een iets hoger aantal acute afstotingen bij dagoperaties. Deze bevindingen bieden transplantatieteams geruststelling: een onvoorspelbare donorbeschikbaarheid hoeft niet te leiden tot een verminderde klinische uitkomst.

## English: Impact of Operative Time on Pediatric Heart Transplant Outcomes: An Analysis of the United Network for Organ Sharing Registry.

An analysis of 6,125 pediatric heart transplants from the UNOS registry (2000–2018) found that operative timing (day vs. night) and day of the week (weekday vs. weekend) do not significantly impact patient or graft survival. Multivariable Cox regression confirmed these findings (HR 0.97 for night vs. day; HR 1.04 for weekend vs. weekday), despite a slightly higher rate of acute rejection in daytime procedures. These results reassure transplant teams that unpredictable donor availability does not compromise clinical outcomes.

## Abstract (original, from the publication)

BACKGROUND: Heart transplantation is definitive therapy for children with end-stage heart failure. Because donor availability is unpredictable, transplantation occurs overnight or on weekends. Although studies report mixed findings on the association between operative timing and outcomes, pediatric data remain limited. We evaluated the impact of operative timing on pediatric heart transplant outcomes. METHODS: We studied pediatric heart transplant recipients (< 18 years) in the United Network for Organ Sharing registry from 2000 to 2018. Transplants were classified by time of day (day: 9 AM-8:59 PM; night: 9 PM-8:59 AM) and day of week (weekday vs. weekend). Primary outcome was survival. Secondary outcomes included graft survival, rejection, retransplantation, and postoperative complications. Survival was analyzed using Kaplan-Meier and log-rank testing. Multivariable Cox regression adjusted for recipient and donor characteristics and pre-transplant support. RESULTS: Among 6125 recipients, 2930 (47.8%) transplants occurred during the day and 3195 (52.2%) at night; 4408 (72.0%) occurred on weekdays and 1717 (28.0%) on weekends. Kaplan-Meier analysis demonstrated no significant survival difference between daytime and nighttime transplants (p = 0.266) or weekday and weekend transplants (p = 0.210). In multivariable Cox regression, operative timing was not associated with mortality (night vs. day: hazard ratio 0.97, 95% confidence interval 0.89-1.06, p = 0.554; weekend versus weekday: hazard ratio 1.04, 95% confidence interval 0.94-1.15, p = 0.445). Acute rejection prior to discharge and treatment for rejection within 1 year was more frequent in daytime transplants without affecting graft survival. CONCLUSIONS: Operative timing was not associated with patient survival, graft survival, or postoperative outcomes after pediatric heart transplantation.

Auteurs: Akosua Dansoa Odei, Haoran Jiang, Natasha Anders, Seth Erasmus Murray Wolf, Chelsea Harris, Rebekah Boyd, Matthew Galen Hartwig, Douglas Marvin Overbey, Joseph William Turek

---
Bron: Pediatric transplantation, https://doi.org/10.1111/petr.70474. Bijgewerkt 2026-10-02T01:21:00Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.