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Matching Donor and Recipient Size in Pediatric Heart Transplantation

Previous analyses in pediatric heart transplant (HT) recipients using weight or height have not found donor-recipient size-mismatch to be associated with post-transplant mortality. A recent study in 3,215 normal US children developed an equation for left ventricular (LV) mass using body surface area...

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Autores principales: Singh, Tajinder P., Colan, Steven D., Gauvreau, Kimberlee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842272/
https://www.ncbi.nlm.nih.gov/pubmed/35185381
http://dx.doi.org/10.3389/ti.2022.10226
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author Singh, Tajinder P.
Colan, Steven D.
Gauvreau, Kimberlee
author_facet Singh, Tajinder P.
Colan, Steven D.
Gauvreau, Kimberlee
author_sort Singh, Tajinder P.
collection PubMed
description Previous analyses in pediatric heart transplant (HT) recipients using weight or height have not found donor-recipient size-mismatch to be associated with post-transplant mortality. A recent study in 3,215 normal US children developed an equation for left ventricular (LV) mass using body surface area (BSA). We assessed whether donor-recipient size match using predicted LV mass (PLM) is associated with post-transplant in-hospital mortality or 1-year graft survival. We identified 4,717 children <18 yrs old who received primary HT in the US during 01/2000 to 03/2015 and divided them into five groups [10%, 10%, 60% (reference group), 10% and 10%, respectively] with increasing donor-recipient PLM ratio. In adjusted analysis, group 1 children (PLM ratio ≤.90) were at higher risk of post-transplant in-hospital mortality [Odds Ratio (OR) 1.55, 95% CI 1.04, 2.31]. This association of the most undersized donors with recipient in-hospital mortality was similar when donor-recipient weight ratio<.88 or BSA ratio<.92 (lowest decile) were used instead. There was no difference in 1-year graft survival among groups. Utilizing donors with donor-recipient PLM ratio ≤.90 is associated with higher risk of early post-transplant mortality in pediatric HT recipients. However, this metric is not superior to donor-recipient weight ratio or BSA ratio for assessing size match.
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spelling pubmed-88422722022-02-17 Matching Donor and Recipient Size in Pediatric Heart Transplantation Singh, Tajinder P. Colan, Steven D. Gauvreau, Kimberlee Transpl Int Health Archive Previous analyses in pediatric heart transplant (HT) recipients using weight or height have not found donor-recipient size-mismatch to be associated with post-transplant mortality. A recent study in 3,215 normal US children developed an equation for left ventricular (LV) mass using body surface area (BSA). We assessed whether donor-recipient size match using predicted LV mass (PLM) is associated with post-transplant in-hospital mortality or 1-year graft survival. We identified 4,717 children <18 yrs old who received primary HT in the US during 01/2000 to 03/2015 and divided them into five groups [10%, 10%, 60% (reference group), 10% and 10%, respectively] with increasing donor-recipient PLM ratio. In adjusted analysis, group 1 children (PLM ratio ≤.90) were at higher risk of post-transplant in-hospital mortality [Odds Ratio (OR) 1.55, 95% CI 1.04, 2.31]. This association of the most undersized donors with recipient in-hospital mortality was similar when donor-recipient weight ratio<.88 or BSA ratio<.92 (lowest decile) were used instead. There was no difference in 1-year graft survival among groups. Utilizing donors with donor-recipient PLM ratio ≤.90 is associated with higher risk of early post-transplant mortality in pediatric HT recipients. However, this metric is not superior to donor-recipient weight ratio or BSA ratio for assessing size match. Frontiers Media S.A. 2022-02-07 /pmc/articles/PMC8842272/ /pubmed/35185381 http://dx.doi.org/10.3389/ti.2022.10226 Text en Copyright © 2022 Singh, Colan and Gauvreau. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Singh, Tajinder P.
Colan, Steven D.
Gauvreau, Kimberlee
Matching Donor and Recipient Size in Pediatric Heart Transplantation
title Matching Donor and Recipient Size in Pediatric Heart Transplantation
title_full Matching Donor and Recipient Size in Pediatric Heart Transplantation
title_fullStr Matching Donor and Recipient Size in Pediatric Heart Transplantation
title_full_unstemmed Matching Donor and Recipient Size in Pediatric Heart Transplantation
title_short Matching Donor and Recipient Size in Pediatric Heart Transplantation
title_sort matching donor and recipient size in pediatric heart transplantation
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842272/
https://www.ncbi.nlm.nih.gov/pubmed/35185381
http://dx.doi.org/10.3389/ti.2022.10226
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