{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:40:44Z","timestamp":1762940444998,"version":"3.45.0"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Pre\u2010transplant (PreTX) diagnoses of congenital heart disease (CHD), including single ventricle (SV) CHD, are known to be associated with immediate post\u2010operative morbidity and mortality. However, the impact on post\u2010discharge health and morbidity has not been elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Pediatric Health Information Survey (PHIS) data was used to identify patients undergoing orthotopic heart transplantation (HT). We assessed hospital encounters for readmission, ICU care, and interventions within 1\u2009year of heart transplantation after discharge from HT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 4087 patients were included in the analysis with the median age of 5.2\u2009years. PreTX diagnosis was CHD in 28%, single ventricle CHD (SV) in 31%, cardiomyopathy, and other causes in 41%. A total of 2698 patients (66%) required hospital readmission within 1\u2009year of discharge, of which 569 required more than two readmissions. The reason for readmission was cardiac in 22%, infectious in 35%, and non\u2010cardiac in 43%. Using multivariable modeling, younger age, CHD, SV, Hispanic race, government insurance, longer post\u2010TX hospital stay, longer ventilation needs, and dialysis use were associated with readmission risk (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). CHD and SV diagnosis, younger age, and longer post\u2010TX stay were also risk factors for ICU\u2010level readmission (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Regression analysis showed that CHD (HR 2.7) and SV (HR 5.3) were highly predictive of reinterventions within 1\u2009year. Lastly, the morbidity burden was calculated as days alive and outside hospital (DAOH) post TX. Younger age, SV, current era for transplantation, prolonged ventilation, and hospital stay post TX were all associated with lower DAOH.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CHD and SV have a significant impact on continued morbidity post\u2010TX, including the need for ICU\u2010level readmission and reinterventions. The study also identifies race and post\u2010TX morbidities as other important risk factors for readmissions and reinterventions. We need to study and improve the optimization of patients pre\u2010and post\u2010TX to mitigate this significant and continued risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70180","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T13:21:36Z","timestamp":1758201696000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre\u2010Transplant Diagnosis Asserts Significant Post\u2010Transplant Burden on Readmissions and Reinterventions: A Multicenter Study"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3731-5984","authenticated-orcid":false,"given":"Mario","family":"O'Connor","sequence":"first","affiliation":[{"name":"Texas Center for Pediatric and Congenital Heart Disease Dell Children's and UT Health  Austin Texas USA"},{"name":"Department of Surgery and Perioperative Care Dell Medical School at the University of Texas  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Well","sequence":"additional","affiliation":[{"name":"Texas Center for Pediatric and Congenital Heart Disease Dell Children's and UT Health  Austin Texas USA"},{"name":"Department of Surgery and Perioperative Care Dell Medical School at the University of Texas  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3655-7930","authenticated-orcid":false,"given":"Hugo R.","family":"Martinez","sequence":"additional","affiliation":[{"name":"Texas Center for Pediatric and Congenital Heart Disease Dell Children's and UT Health  Austin Texas USA"},{"name":"Department of Pediatrics Dell Medical School at the University of Texas  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura R.","family":"Norris","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children's National, Georgetown University School of Medicine  Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bibhuti","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children's Mississippi, University of Mississippi Medical Center  Jackson Mississippi USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shriprasad R.","family":"Deshpande","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children's National, Georgetown University School of Medicine  Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.05.016"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.05.009"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.01.019"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.08.038"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/pir001"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.6002\/ect.2020.0349"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.08.002"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20103046.2011.01564.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12857"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.02.053"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.05.017"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab724.0954"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.08.018"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13561"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.030821"},{"key":"e_1_2_7_17_1","unstructured":"R Core Team \u201cR: A Language and Environment for Statistical Computing \u201d(2019) https:\/\/www.R\u2010project.org\/."},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2004.05.047"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020\u20101240"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2023.10.027"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000000725"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.07.039"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.05.043"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/2150135118762401"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.06.042"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2022.07.033"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.optechstcvs.2019.08.002"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951114001437"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2021.104093"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.13066"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472\u20106963\u201010\u2010248"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010024\u201019046\u2010z"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201021936\u20104"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.15146"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2023.09.039"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.06.037"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.01.1231"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70180","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:37:02Z","timestamp":1762940222000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,18]]},"references-count":36,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/petr.70180"],"URL":"https:\/\/doi.org\/10.1111\/petr.70180","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"type":"print","value":"1397-3142"},{"type":"electronic","value":"1399-3046"}],"subject":[],"published":{"date-parts":[[2025,9,18]]},"assertion":[{"value":"2025-06-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70180"}}