Donor-recipient height ratio and outcomes in pediatric heart transplantation.
Height matching in pediatric HTx 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 HTx 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 HTx 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-HTx 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 HTx recipients with DCM, other factors play a more important role as height matching loses significance in multivariate analysis.
Division of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Anjlee
A
Patel
Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Matthew J
MJ
Bock
Division of Pediatric Cardiothoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Adi
A
Wollstein
Division of Pediatric Cardiothoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Khanh
K
Nguyen
Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Stefano
S
Malerba
Division of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Irene D
ID
Lytrivi
D000293:Adolescent; D001827:Body Height; D002311:Cardiomyopathy, Dilated / Q000401:mortality / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D046148:Donor Selection / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
heart transplantation; height match; pediatrics