title: Use of height and a novel echocardiographic measurement to improve size-matching for pediatric heart transplantation.
abstract: BACKGROUND
  A major limitation of pediatric heart transplantation is scarcity of pediatric donor organs, leading to longer waiting times and higher waiting list mortality. Current practice is to match potential pediatric recipients with donors by weight; however, we hypothesize height to be a better predictor of heart size as estimated by left ventricular end-diastolic diameter (LVEDd), as well as a novel measurement from the superior vena cava-right atrium junction to inferior vena cava-right atrium junction (SVC-IVC distance). Our ultimate objective is to present a more effective means of size-matching for pediatric heart transplantation.
  
  
  METHODS
  Measurements of LVEDd and SVC-IVC distance were taken from 254 normal echocardiograms performed on individuals aged 7 days to 22 years, and correlated with demographic variables, including height, weight, and body surface area. Simulations were conducted using echocardiographic measurements and size parameters of past recipients with hypothetic donors to demonstrate practicality.
  
  
  RESULTS
  There was a linear relationship between height and SVC-IVC distance (R(2) = 0.904) and LVEDd (R(2) = 0.889), whereas the relationships with weight were logarithmic (SVC-IVC distance, R(2) = 0.855; LVEDd, R(2) = 0.880), and the relationships with body surface area were polynomial (SVC-IVC distance, R(2) = 0.880; LVEDd, R(2) = 0.884). Three simulations demonstrate improvements in efficiency of the size-matching process.
  
  
  CONCLUSIONS
  The use of height and a novel SVC-IVC distance measurement to evaluate heart size in potential pediatric heart transplant recipients and donors may allow for broadening of the donor pool and creation of a more efficient and accurate size-matching process. The prospective evaluation of these novel methods with respect to clinical outcomes is necessary.
authors.affiliation: Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY 10032, USA. wz2116@columbia.edu
authors.forename: Warren A
authors.initials: WA
authors.lastname: Zuckerman
authors.forename: Marc E
authors.initials: ME
authors.lastname: Richmond
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Singh
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Chen
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Addonizio
mesh_terms: D000293:Adolescent; D001827:Body Height; D001830:Body Surface Area; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006321:Heart / Q000033:anatomy & histology*; D006325:Heart Atria / Q000033:anatomy & histology; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009929:Organ Size; D011446:Prospective Studies; D014682:Vena Cava, Inferior / Q000033:anatomy & histology; D014683:Vena Cava, Superior / Q000033:anatomy & histology; D055815:Young Adult