{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T12:38:18Z","timestamp":1751373498663},"reference-count":16,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2022,11,1]]},"abstract":"Importance<\/jats:title>The United Network for Organ Sharing (UNOS) evaluates donor risk for acute transmission of HIV, hepatitis B, or hepatitis C based on US Public Health Services (PHS)\u2013specific criteria. However, recent data regarding use and outcomes of those donors with PHS risk criteria among pediatric and adult heart transplant recipients are lacking.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare use and outcomes of graft from donors with PHS risk criteria vs those with a standard-risk donor (SRD) in children vs adults in a contemporary cohort.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort was a nationwide analysis of heart transplants in the US that used data from the UNOS database. Participants were children (&amp;lt;18 years old) and adults (\u226518 years old) who received a heart transplant from January 1, 2010, to December 31, 2021.<\/jats:p><\/jats:sec>Exposures<\/jats:title>UNOS-defined donor risk status.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Trend analysis compared changes in PHS risk criteria use among children and adults. Patient survival was analyzed using Kaplan-Meier curves with log rank and Cox proportional hazards to compare PHS risk-criteria outcomes vs SRD-criteria outcomes in children and adult heart transplant recipients. Additional analysis was performed among adults who received a PHS\u2013risk criteria graft that was previously declined for pediatric recipients.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 5115 pediatric transplant recipients (donor without PHS risk median [IQR] age, 5 [0-13] years and donor with PHS risk median [IQR] age, 8 [0-14] years) and 30\u202f289 adult heart transplant recipients (donor without PHS risk median [IQR] age, 56 [46-63] years and donor with PHS risk median [IQR] age, 57 [47-63] years), PHS risk criteria comprised 8% in children vs 25% in adults. PHS criteria are being increasingly used over the past decade with the proportion of recipients transplanted with PHS risk-criteria donors being approximately 3 times greater among adult recipients than children recipients. Pediatric recipients of a PHS risk-criteria donor had greater pretransplant ventilatory support, whereas adult recipients of a PHS risk-criteria donor had greater pretransplant extracorporeal membrane oxygenation use. Patient survival was similar between pediatric recipients of PHS risk-criteria grafts vs SRD-criteria grafts and slightly higher among adult recipients of PHS risk-criteria grafts vs SRD-criteria grafts. The 1778 adult recipients who received a PHS criteria-risk donor that was previously declined for pediatric recipients had similar patient survival recipients compared with SRD-criteria donors (HR, 0.92; 95% CI, 0.81-1.03; P<\/jats:italic>\u2009=\u2009.18).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In the current era, a 3-fold greater proportion of adult recipients receive a PHS risk-criteria graft compared with children despite similar posttransplant patient survival. The ongoing organ donor shortage underscores the need for consideration of PHS risk criteria where these donors remain underused.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamacardio.2022.3070","type":"journal-article","created":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T15:02:35Z","timestamp":1663772555000},"page":"1121","source":"Crossref","is-referenced-by-count":6,"title":["Association of Donors With US Public Health Service Risk Criteria and Outcomes After Adult vs Pediatric Cardiac Transplant"],"prefix":"10.1001","volume":"7","author":[{"given":"Danielle S.","family":"Burstein","sequence":"first","affiliation":[{"name":"Cardiology, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph W.","family":"Rossano","sequence":"additional","affiliation":[{"name":"Cardiology, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JoAnn","family":"Lindenfeld","sequence":"additional","affiliation":[{"name":"Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly H.","family":"Schlendorf","sequence":"additional","affiliation":[{"name":"Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nhue","family":"Do","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Godown","sequence":"additional","affiliation":[{"name":"Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"Cardiology, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhide","family":"Maeda","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan B.","family":"Edelson","sequence":"additional","affiliation":[{"name":"Cardiology, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly Y.","family":"Lin","sequence":"additional","affiliation":[{"name":"Cardiology, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy A.","family":"Mazurek","sequence":"additional","affiliation":[{"name":"Cardiology, Hospital of University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelley R.","family":"Scholl","sequence":"additional","affiliation":[{"name":"Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan N.","family":"Menachem","sequence":"additional","affiliation":[{"name":"Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","reference":[{"key":"hoi220053r1","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1111\/ajt.v21.s2","article-title":"OPTN\/SRTR 2019 Annual data report: heart.","volume":"21","author":"Colvin","year":"2021","journal-title":"Am J Transplant"},{"issue":"10","key":"hoi220053r2","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1016\/j.healun.2020.07.008","article-title":"The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: 23rd pediatric heart transplantation report-2020; 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