{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:42:03Z","timestamp":1753879323977,"version":"3.41.2"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"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":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Children listed for heart transplantation face the highest waitlist mortality among all solid organ transplant patients (14%). Attempts at decreasing donor allograft non\u2010utilization (41.5%) could potentially decrease waitlist mortality for pediatric heart transplant patients. Our aim was to quantify the non\u2010utilization risk of pediatric donor heart allografts at the time of initial offering.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the United Network of Organ Sharing (UNOS) database, we retrospectively analyzed 8823 deceased donors (\u226418\u2009years old) data through univariable and multivariable analysis and logistic regression models. These factors were divided into a training (<jats:italic>n<\/jats:italic>\u2009=\u20095882) and validation set (<jats:italic>n<\/jats:italic>\u2009=\u20092941). Donor clinical characteristics and laboratory values were used to predict non\u2010utilization of donor hearts. The multivariable analysis used factors that were significant from the univariable analysis (<jats:italic>p<\/jats:italic>\u2010value\u2009&lt;\u2009.05), and the pediatric non\u2010utilization risk index (pDRSI) included significant factors from the multivariable analysis, producing an overall risk score for non\u2010utilization. With these data, we created a non\u2010utilization risk index to predict likelihood of donor allograft non\u2010utilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From the 24 potential factors that were identified from univariable analysis, 17 were significant predictors (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) of pediatric heart non\u2010utilization in the multivariable analysis. Low left ventricular ejection fraction (odds ratio (OR)\u201035.3), hepatitis C positive donor (OR\u201023.3), high left ventricular ejection fraction (OR\u20103.29), and hepatitis B positive donor (OR\u20103.27) were the most significant risk factors. The phDSRI has a C\u2010statistic of 0.80 for the training set and 0.80 for the validation set.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Using over 8000 donors, the phDSRI uses 17 significant risk factors to predict risk of pediatric heart donor allograft non\u2010utilization.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14629","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T12:18:55Z","timestamp":1705666735000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Index Predicts Pediatric Heart Allograft Non\u2010Utilization"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7600-4353","authenticated-orcid":false,"given":"Jake","family":"Lynn","sequence":"first","affiliation":[{"name":"Department of Student Affairs Baylor College of Medicine  Houston Texas 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