{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:32:24Z","timestamp":1792171944528,"version":"4.4.0"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T00:00:00Z","timestamp":1581897600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pediatric heart\u2010lung transplantation (HLT) is rare, and no report has analyzed patient outcomes since time of listing. We analyzed pediatric HLTs to understand risk factors for waitlist and post\u2010HLT mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All pediatric (&lt;18\u00a0year old) HLT candidates were identified within the UNOS database (n\u00a0=\u00a0573) and grouped by age, era, and by diagnosis. Logistical regression and Cox proportional hazard modeling identified risk factors for 6\u2010month WL and overall post\u2010transplant mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>209\/573 (37%) HLT candidates were transplanted, 7% recovered, 42% died waiting, and 15% were removed for another\/unknown reason. Diagnoses were primary pulmonary hypertension(n\u00a0=\u00a0130), congenital heart disease(CHD) without Eisenmenger's syndrome (ES) (n\u00a0=\u00a065), CHD with ES (n\u00a0=\u00a073), and other (n\u00a0=\u00a0305). Patients with a diagnosis other than CHD with ES (OR: 7.55, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001), on IV inotropic support (OR: 2.79, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), and infants (OR: 2.20, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.004) were associated with waitlist mortality. There has been a 56% reduction in HLTs across eras (Era 1:10.8\/yr vs Era 2:4.7\/yr). Risk factors for post\u2010transplant mortality were ECMO (HR: 4.1, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.016), and being infant (HR: 2.2, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04) or 1\u201011\u00a0years old (HR: 1.78, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.015). ECMO patients have an 87% 2\u2010year mortality rate with a median post\u2010transplant survival of 64\u00a0days. Overall, post\u2010transplant survival was unchanged (log\u2010rank <jats:italic>P<\/jats:italic>\u00a0=\u00a0.067) between eras. Excluding ECMO patients, in the recent era 29 non\u2010infant patients with primary pulmonary hypertension had 93% 1\u2010year survival and 67% 5\u2010year survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nearly 600 pediatric patients have been listed for HLT in UNOS, although numbers are decreasing in the current era. HLT for a patient on ECMO appears to be an ineffective strategy; however, in well\u2010selected cohorts, HLT can provide considerable post\u2010transplant survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.13682","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T06:39:44Z","timestamp":1582007984000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Pediatric heart\u2010lung transplantation: A contemporary analysis of outcomes"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8045-0738","authenticated-orcid":false,"given":"Kyle W.","family":"Riggs","sequence":"first","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Cincinnati Ohio"},{"name":"Department of Cardiothoracic Surgery Northwell Health Manhasset New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacquelyn L.","family":"Chapman","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Cincinnati Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Schecter","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Cincinnati Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Towe","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Cincinnati Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhan","family":"Zafar","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Cincinnati Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L. S.","family":"Morales","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Cincinnati Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12208"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.12.014"},{"key":"e_1_2_7_4_1","unstructured":"Heart and Lung Transplant | Children\u2019s Heart Institute.Children\u2019s Hospital of Pittsburgh. Retrieved fromhttp:\/\/www.chp.edu\/our-services\/heart\/heart-lung-transplant. Accessed 15 November 2018."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.07.017"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.07.016"},{"issue":"7","key":"e_1_2_7_7_1","first-page":"692","article-title":"Pediatric heart\u2010lung transplantation: intermediate\u2010term results","volume":"15","author":"Conte JV","year":"1996","journal-title":"J Heart Lung Transpl"},{"key":"e_1_2_7_8_1","unstructured":"About. UNOS. Retrieved fromhttps:\/\/unos.org\/about\/. Published January 13 2015."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1053-2498(99)00087-X"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15278"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15279"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(92)91338-A"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2150135118815876"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-965414"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.12.004"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpetr.13682","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.13682","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.13682","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.13682","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T10:48:45Z","timestamp":1693392525000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.13682"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,17]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1111\/petr.13682"],"URL":"https:\/\/doi.org\/10.1111\/petr.13682","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,17]]},"assertion":[{"value":"2019-12-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13682"}}