Adults with congenital heart disease (CHD) appear to have high 30-day mortality rates after heart transplantation but also have better late survival after their transplant procedure. Researchers in the United States found that early mortality among patients with CHD was high, but overall survival was equivalent by 10 years (53.8% vs 53.6%). Mechanical circulatory assistance did not improve waiting-list survival in the study. The authors theorized that this may be due to a combination of highly complex reoperative surgery and poor preoperative systemic health. CHD patients were more likely to have a BMI less than 18.5 kg/m2 at transplantation, were younger, and had fewer comorbidities.