{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:40:08Z","timestamp":1753879208633,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K24AI144954","F32AG082486","1F32DK136310\u201001A1"],"award-info":[{"award-number":["K24AI144954","F32AG082486","1F32DK136310\u201001A1"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pretransplant functional, motor, cognitive, and academic deficits are common in pediatric patients requiring heart transplantation (HT); some persist post\u2010HT. We assessed the association between these quality of life (QoL) deficits and post\u2010HT outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using SRTR data 2008\u20132023, we evaluated the functional, motor, cognitive, and academic status of pediatric HT recipients from listing to 15\u2009years post\u2010HT. We compared all\u2010cause graft survival among patients with vs. without pre\u2010HT deficits using Cox regressions. Among patients with a functioning graft at 1 year, we assessed the association between deficits at that time and subsequent graft failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 6153 HT recipients, 85.3% had pre\u2010HT functional status \u2264\u200980%, 53.1% of patients could not tolerate a full academic load; this decreased to 15.2% and 15.0% postoperatively, and was sustained. Definite or probable cognitive deficits were seen in 17.4% of patients and motor delays in 18.6%; both remained stable post\u2010HT at 18.0% and 16.4%, respectively. Graft survival was worse in those with either pre\u2010 or post\u2010HT deficits in functional status. Worse pre\u2010HT functional status was associated with risk of graft failure (adjusted hazard ratio [aHR] per 10% decrease\u2009=\u2009<jats:sub>1.03<\/jats:sub> 1.06 <jats:sub>1.08<\/jats:sub>, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); worse 1\u2010year post\u2010HT functional status was much more strongly associated with risk of graft failure (aHR\u2009=\u2009<jats:sub>1.13<\/jats:sub> 1.18 <jats:sub>1.23<\/jats:sub>, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pediatric HT recipients with decreased functional status are at higher risk for graft failure and mortality. These patients may benefit from early intervention aimed at improving functional status.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14874","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T08:39:34Z","timestamp":1732523974000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Deficits in Pre\u2010 and Post\u2010transplant Functional, Motor, and Cognitive Deficits Associated With Graft Failure and Mortality in Pediatric Heart Transplant Recipients"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0826-8107","authenticated-orcid":false,"given":"Conor","family":"Donnelly","sequence":"first","affiliation":[{"name":"Department of Surgery, Transplant Institute NYU Langone Health  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5925-9925","authenticated-orcid":false,"given":"Suhani S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Surgery, Transplant Institute NYU Langone Health  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0601-7420","authenticated-orcid":false,"given":"Teresa Po\u2010Yu","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Transplant Institute NYU Langone Health  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0573-6597","authenticated-orcid":false,"given":"Luckmini","family":"Liyanage","sequence":"additional","affiliation":[{"name":"Department of Surgery, Transplant Institute NYU Langone Health  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1135-6697","authenticated-orcid":false,"given":"Jane J.","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Surgery, Transplant Institute NYU Langone Health  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4239-1252","authenticated-orcid":false,"given":"Macey L.","family":"Levan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Transplant Institute NYU Langone Health  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1460-5583","authenticated-orcid":false,"given":"Manu R.","family":"Varma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics NYU Langone Health  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7410-6209","authenticated-orcid":false,"given":"Rakesh K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics NYU Langone Health  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-4801","authenticated-orcid":false,"given":"Dorry L.","family":"Segev","sequence":"additional","affiliation":[{"name":"Department of Surgery, Transplant Institute NYU Langone Health  New York New York USA"},{"name":"Scientific Registry of Transplant Recipients  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5288-5125","authenticated-orcid":false,"given":"Allan B.","family":"Massie","sequence":"additional","affiliation":[{"name":"Department of Surgery, Transplant Institute NYU Langone Health  New York New York 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