{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T03:11:49Z","timestamp":1771297909030,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RO1DK102981"],"award-info":[{"award-number":["RO1DK102981"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pediatric sHKTx remains uncommon in the US. We examined outcomes of pediatric sHKTx compared to PHTx alone. Our objective was to identify a threshold eGFR that justified pediatric sHKTx.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from the SRTR heart and kidney databases were used to identify 9245 PHTx, and 63 pediatric sHKTx performed between 1992 and 2017 (age \u226421\u00a0years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age for sHKTx was 16\u00a0years, and included 31 males (31\/63\u00a0=\u00a049%). Over half of sHKTx (36\/63\u00a0=\u00a057%) were performed in cases where pretransplant dialysis was initiated. Among patients who required pretransplant dialysis, the risk of death in sHKTx recipients was significantly lower than PHTx alone (sHKTx vs. PHTx: HR 0.4, 95% CI [0.2, 0.9], <jats:italic>p<\/jats:italic>\u00a0=\u00a0.01). In those without pretransplant dialysis, there was no improvement in survival between sHKTx and PHTx (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.2). When stratified by eGFR, PHTx alone recipients had worse survival than sHKTx in the group with eGFR \u226435\u00a0ml\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup> (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.04). The 1\u2010 and 5\u2010year actuarial survival rates in pediatric sHKTx recipients were 87% and 81.5% respectively and was similar to isolated PHTx (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.5). One\u2010year rates of treated heart (11%) and kidney (7.9%) rejection were similar in sHKTx compared to PHTx alone (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.7) and pediatric kidney transplant alone (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.5) respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pediatric sHKTx should be considered in HTx candidates with kidney failure requiring dialysis or eGFR \u226435\u00a0ml\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>. The utility of sHKTx in cases of kidney failure not requiring dialysis warrants further study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14149","type":"journal-article","created":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T05:55:53Z","timestamp":1632894953000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Simultaneous pediatric heart\u2010kidney transplant outcomes in the US: A\u201025 year National Cohort Study"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9240-1711","authenticated-orcid":false,"given":"Swati","family":"Choudhry","sequence":"first","affiliation":[{"name":"Section of Pediatric Cardiology Department of Pediatrics Texas Children\u2019s Hospital Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4206-7257","authenticated-orcid":false,"given":"Susan W.","family":"Denfield","sequence":"additional","affiliation":[{"name":"Section of Pediatric Cardiology Department of Pediatrics Texas Children\u2019s Hospital Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8000-1385","authenticated-orcid":false,"given":"Vikas R.","family":"Dharnidharka","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Hypertension and Pheresis Department of Pediatrics Washington University School of Medicine Saint Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunfei","family":"Wang","sequence":"additional","affiliation":[{"name":"Section of Pediatric Cardiology Department of Pediatrics Texas Children\u2019s Hospital Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hari P.","family":"Tunuguntla","sequence":"additional","affiliation":[{"name":"Section of Pediatric Cardiology Department of Pediatrics Texas Children\u2019s Hospital Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio G.","family":"Cabrera","sequence":"additional","affiliation":[{"name":"Section of Pediatric Cardiology Department of Pediatrics University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack F.","family":"Price","sequence":"additional","affiliation":[{"name":"Section of Pediatric Cardiology Department of Pediatrics Texas Children\u2019s Hospital Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William J.","family":"Dreyer","sequence":"additional","affiliation":[{"name":"Section of Pediatric Cardiology Department of Pediatrics Texas Children\u2019s Hospital Baylor College of Medicine Houston Texas 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