{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T17:19:32Z","timestamp":1789838372431,"version":"4.0.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Infants awaiting paediatric heart transplantation (PHT) experience long waitlist duration and high mortality due to donor shortage. Using the United Network for Organ Sharing database, we explored if increasing donor\u2013recipient weight ratio (DRWR) &amp;gt;2.0 (recommended cutoff) was associated with adverse outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Between 2007 and 2020, 1392 infants received PHT. We divided cohort into 3 groups: A (DRWR \u22641.0, n\u2009=\u2009239, 17%), B (DRWR 1.0\u20132.0, n\u2009=\u2009947, 68%), C (DRWR &amp;gt;2.0, n\u2009=\u2009206, 15%). Group characteristics and PHT outcomes were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>DRWR ranged between 0.5 and 4.1. Underlying pathology (congenital versus cardiomyopathy), gender, race, renal function and mechanical circulatory support were comparable between groups. Group C patients were more likely to be ventilated, to receive ABO blood group (ABO)-incompatible heart and to have longer donor ischaemic time. Waitlist duration was significantly shorter for group C (33 vs 50\u2009days, P\u2009&amp;lt;\u20090.1). Early outcomes for groups A, B and C were the following (respectively): operative death (6%, 4%, 3%, P\u2009=\u20090.29), primary graft dysfunction (5%, 3%, 3%, P\u2009=\u20090.30), renal failure (10%, 7%, 7%, P\u2009=\u20090.42) and stroke (3%, 4%, 1%, P\u2009=\u20090.36). The DRWR group was not associated with operative death in either congenital (odds ratio (OR)\u2009=\u20090.819, 95% confidence interval (CI)\u2009=\u20090.523\u20131.282) or cardiomyopathy (OR\u2009=\u20091.221, 95% CI\u2009=\u20090.780\u20131.912) patients and only significant factor was pre-PHT extracorporeal membrane oxygenation (OR\u2009=\u20094.400, 95% CI\u2009=\u20092.761\u20137.010). Additionally, survival at 1\u2009year (87%, 87%, 85%, P\u2009=\u20090.80) and 5\u2009years (76%, 78%, 77%, P\u2009=\u20090.80) was comparable between the DRWR groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Infants who received PHT with DRWR &amp;gt;2.0, up to 4.1, experienced shorter waitlist duration with no demonstrable increase in peri-transplant complications, operative or late mortality. Historic practice to avoid DRWR\u2009&amp;gt;\u20092.0 due to complications (e.g. hypertension-related stroke, graft dysfunction, death) is not currently supported in infants and stretching DRWR acceptance criteria would decrease PHT waitlist duration and potentially improve waitlist complications and mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad316","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T05:08:50Z","timestamp":1694495330000},"source":"Crossref","is-referenced-by-count":5,"title":["Increasing donor\u2013recipient weight mismatch in infant heart transplantation is associated with shorter waitlist duration and no increased morbidity or mortality"],"prefix":"10.1093","volume":"64","author":[{"given":"Bahaaldin","family":"Alsoufi","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Louisville and Norton Children\u2019s Hospital , Louisville, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Kozik","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Louisville and Norton Children\u2019s Hospital , Louisville, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Nicole","family":"Lambert","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Louisville and Norton Children\u2019s Hospital , Louisville, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Wilkens","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Louisville and Norton Children\u2019s Hospital , Louisville, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaimin","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Louisville and Norton Children\u2019s Hospital , Louisville, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shriprasad","family":"Deshpande","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiac Critical Care, Children\u2019s National Hospital , Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,13]]},"reference":[{"key":"2023122115382734700_ezad316-B1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.healun.2014.09.018","article-title":"Pediatric heart transplant waiting list mortality in the era of ventricular assist devices","volume":"34","author":"Zafar","year":"2015","journal-title":"J Heart Lung Transplant"},{"key":"2023122115382734700_ezad316-B2","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/j.healun.2021.07.022","article-title":"The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: twenty-fourth pediatric heart transplantation report - 2021; focus on recipient characteristics","volume":"40","author":"Singh","year":"2021","journal-title":"J Heart Lung Transplant"},{"key":"2023122115382734700_ezad316-B3","doi-asserted-by":"crossref","first-page":"e13671","DOI":"10.1111\/petr.13671","article-title":"Pediatric cardiac waitlist mortality\u2014still too high","volume":"24","author":"Denfield","year":"2020","journal-title":"Pediatr Transplant"},{"key":"2023122115382734700_ezad316-B4","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1016\/j.healun.2009.06.013","article-title":"Incidence and risk factors for mortality in infants awaiting heart transplantation in the USA","volume":"28","author":"Mah","year":"2009","journal-title":"J Heart Lung Transplant"},{"key":"2023122115382734700_ezad316-B5","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.healun.2020.01.1345","article-title":"ISHLT consensus statement on donor organ acceptability and 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