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Donor–recipient height ratio and outcomes in pediatric heart transplantation
Author(s) -
Patel Anjlee,
Bock Matthew J.,
Wollstein Adi,
Nguyen Khanh,
Malerba Stefano,
Lytrivi Irene D.
Publication year - 2016
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12734
Subject(s) - medicine , multivariate analysis , heart transplantation , transplantation , confidence interval , propensity score matching , survival analysis , cardiology , surgery , pediatrics
Abstract Height matching in pediatric HT x has been proposed as a superior method of evaluating graft size, but no studies have examined survival advantage for height‐matched donor–recipient pairs. We hypothesized that in pediatric patients with DCM , an oversized donor improves survival and aimed to define the optimal height ratio in this patient group. Pediatric primary HT x recipients with DCM between 10/89 and 09/12 were identified in the OPTN database. Patients were stratified into three donor–recipient height and weight ratio categories. One‐ and five‐yr survival was compared using Kaplan–Meier analysis and HRs were computed. A total of 2133 children with DCM who underwent HT x during the study period were included. Unadjusted one‐yr survival was worse for DRHR <0.87 ( HR , 2.15 [95% CL , 1.30, 3.53]; p < 0.01). This difference was not present at five yr post‐ HT x or when stratified by weight. After adjustment for other risk factors affecting transplant survival, height matching was no longer significant. Although height matching appears to predict short‐term survival better than weight in pediatric HT x recipients with DCM , other factors play a more important role as height matching loses significance in multivariate analysis.