Interplay between donor and recipient factors impacts outcomes after pediatric heart transplantation: An analysis from the united network for organ sharing database

Background Donor utilization rates continue to be low for pHT, however, efforts to expand the donor acceptance criteria have shown mixed results in single‐institution studies in pediatric and adult transplantation. Purpose of this study is to assess impact of individual and cumulative donor risk fac...

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Bibliographic Details
Published in:Pediatric transplantation 2021-05, Vol.25 (3), p.e13912-n/a
Main Authors: Das, Bibhuti, Trivedi, Jaimin R., Sinha, Pranava, Ramakrishnan, Karthik, Alsoufi, Bahaaldin, Deshpande, Shriprasad R.
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Coronary artery disease
donor utilization
Female
graft survival
Heart diseases
Heart Transplantation
Humans
Infant
Ischemia
Male
Mortality
outcomes
Pediatric
Pediatrics
Retrospective Studies
Risk Factors
Risk groups
Tissue and Organ Procurement
Tissue Donors
Transplant Recipients
Transplants & implants
Treatment Outcome
Ventricular Function, Left
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Summary:Background Donor utilization rates continue to be low for pHT, however, efforts to expand the donor acceptance criteria have shown mixed results in single‐institution studies in pediatric and adult transplantation. Purpose of this study is to assess impact of individual and cumulative donor risk factors on transplant outcomes as well as the interplay between donor and recipient risk factors as it relates to transplant outcomes. Method We analyzed pHT UNOS data (2008‐2018) to compare the recipient characteristics, donor characteristics, and outcomes based on donor ejection fraction of less than 50% (low EF) and or ischemic time of greater than 4 hours (prolonged IT). Results A total of 4345 pHT were performed of which 1309 (30.1%) were with prolonged IT and 122 (2.8%) in low EF. Additionally, 58 (1.3%) were performed with both low EF and prolonged IT (combined risk). Rest (2856 patients, 65.7%) was considered low risk. Recipients of combined risk were more likely to be younger, have post‐surgical congenital heart disease, be on ECMO or ventilator but less likely on VAD (all P 
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.13912