title: Donor predictors of allograft utilization for pediatric heart transplantation.
abstract: Pediatric heart transplantations are limited by the supply of donor allografts. We sought to determine the cardiac allograft utilization rate for pediatric donors and identify donor factors that predict graft use for transplantation. The United Network for Organ Sharing deceased donor database was queried from April 30, 2006, to March 31, 2014. Donor risk factors that might affect graft use for cardiac transplantation were evaluated. The pediatric cardiac graft utilization rate was calculated, and logistic regression modeling was performed to determine the relationship of risk factors with graft use for transplantation. During the study period, 6682 eligible cardiac donors <18 years of age were identified, and 3758 (56.2%) grafts were utilized for transplantation. Grafts from male donors (OR 1.181) were significantly associated with graft utilization. Graft donor age >1 year (OR 0.363), non-O blood type (OR 0.586), CDC 'high-risk' donor status (OR 0.676), use of inotropes (OR 0.718), use of >2 inotropes (OR 0.328), and donor left ventricular ejection fraction <50% (OR 0.045) were significantly associated with graft nonutilization. The pediatric cardiac allograft utilization rate and risk factors for graft use for transplantation have been identified. Additional studies will be needed to assess the donor-recipient relationship on pediatric transplant outcomes.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Asma M
authors.initials: AM
authors.lastname: Khan
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Green
authors.affiliation: Division of Cardiology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Irene D
authors.initials: ID
authors.lastname: Lytrivi
authors.affiliation: Division of Cardiology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Raj
authors.initials: R
authors.lastname: Sahulee
mesh_terms: D000017:ABO Blood-Group System; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D046148:Donor Selection; D005260:Female; D006085:Graft Survival; D006333:Heart Failure / Q000097:blood / Q000601:surgery*; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D000017:ABO Blood-Group System
keywords: children; donor; graft utilization; pediatric heart transplantation; predictors