{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:43:45Z","timestamp":1763037825339,"version":"3.41.2"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"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":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Infectious complications are a major cause of morbidity and mortality after HT. Fontan patients may be more susceptible to post\u2010HT infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center, retrospective cohort analysis of pediatric patients undergoing HT for FF physiology or DCM, who underwent induction with ATG. The primary endpoint was an infection in the first 180\u2009days post\u2010HT, defined as positive (1) blood\/urine\/respiratory culture; (2) viral PCR; (3) skin or wound infection; and\/or (4) culture\u2010negative infection if \u22655\u2009days of antibiotics were completed. Secondary endpoints included (1) cell counts after ATG; (2) PTLD; and (3) rejection (\u2265Grade 2R ACR or pAMR2) in the first 180\u2009days post\u2010HT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 59 patients (26 FF, 33 DCM) underwent HT at 14.7 (IQR 10.6, 19.5) and 11.7 (IQR 1.4, 13.6) years of age, respectively. The median total ATG received was 7.4 (IQR 4.9, 7.7) vs 7.5 (IQR 7.3, 7.6) mg\/kg (<jats:italic>p<\/jats:italic>\u00a0=\u00a0NS) for FF and DCM patients, respectively. Twenty\u2010three patients (39%) developed an infection 180\u2009days post\u2010HT, with a higher rate of infection in FF patients (54% vs 27%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.03). Adjusted for pre\u2010transplant absolute lymphocyte count, FF patients had a higher risk of infection at 30\u2009days post\u2010HT (OR 7.62, 95% CI 1.13\u201351.48, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.04). There was no difference in the incidence of PTLD (12% vs 0%; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.08) or rejection (12% vs 21%; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.49).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared to DCM patients, FF patients have a higher risk of infection. Modifications to induction therapy for FF patients should be considered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14421","type":"journal-article","created":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T03:49:46Z","timestamp":1666928986000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Increased risk of infections in pediatric Fontan patients after heart transplantation"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1572-4840","authenticated-orcid":false,"given":"Humera","family":"Ahmed","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, Lucile Packard Children's Hospital Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Lucile Packard Children's Hospital Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Lucile Packard Children's Hospital Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6342-2759","authenticated-orcid":false,"given":"David","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Lucile Packard Children's Hospital Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Dykes","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Lucile Packard Children's Hospital Stanford University School of Medicine  Palo Alto California 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