{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:31:52Z","timestamp":1787959912340,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>As more pediatric patients become candidates for heart transplantation (HT), understanding pathological predictors of outcome and the accuracy of the pretransplantation evaluation are important to optimize utilization of scarce donor organs and improve outcomes. The authors aimed to investigate explanted heart specimens to identify pathologic predictors that may affect cardiac allograft survival after HT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Explanted pediatric hearts obtained over an 11\u2010year period were analyzed to understand the patient demographics, indications for transplant, and the clinical\u2013pathological factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, 149 explanted hearts, 46% congenital heart defects (CHD), were studied. CHD patients were younger and mean pulmonary artery pressure and resistance were significantly lower than in cardiomyopathy patients. Twenty\u2010one died or underwent retransplantation (14.1%). Survival was significantly higher in the cardiomyopathy group at all follow\u2010up intervals. There were more deaths and the 1\u2010, 5\u2010 and 7\u2010year survival was lower in patients \u226410\u2009years of age at HT. Early rejection was significantly higher in CHD patients exposed to homograft tissue, but not late rejection. Mortality\/retransplantation rate was significantly higher and allograft survival lower in CHD hearts with excessive fibrosis of one or both ventricles. Anatomic diagnosis at pathologic examination differed from the clinical diagnosis in eight cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Survival was better for the cardiomyopathy group and patients &gt;10\u2009years at HT. Prior homograft use was associated with a higher prevalence of early rejection. Ventricular fibrosis (of explant) was a strong predictor of outcome in the CHD group. We presented several pathologic findings in explanted pediatric hearts.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14742","type":"journal-article","created":{"date-parts":[[2024,5,4]],"date-time":"2024-05-04T06:39:51Z","timestamp":1714804791000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pathology of explanted pediatric hearts: An 11\u2010year study. Population characteristics and implications for outcomes"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8692-5033","authenticated-orcid":false,"given":"Takato","family":"Yamasaki","sequence":"first","affiliation":[{"name":"The Cardiac Registry, Departments of Cardiology, Pathology, and Cardiac Surgery Boston Children's Hospital  Boston Massachusetts USA"},{"name":"Department of Thoracic and Cardiovascular Surgery Mie University Graduate School of Medicine  Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3521-4044","authenticated-orcid":false,"given":"Stephen P.","family":"Sanders","sequence":"additional","affiliation":[{"name":"The Cardiac Registry, Departments of Cardiology, Pathology, and Cardiac Surgery Boston Children's Hospital  Boston Massachusetts USA"},{"name":"Department of Pediatrics Harvard Medical School  Boston Massachusetts 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