{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T17:09:35Z","timestamp":1766336975973,"version":"3.48.0"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"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":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Marfan syndrome (MFS) is a connective tissue disorder associated with significant cardiovascular complications, including heart failure. Orthotopic heart transplantation (OHT) is considered controversial in this population due to concerns about post\u2010transplant aortic complications, particularly in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective review of the Pediatric Health Information System (PHIS) database to identify patients under 18\u2009years of age with a diagnosis of MFS who underwent OHT between 2004 and 2024. Patients were propensity matched (3:1) to non\u2010MFS OHT recipients. Outcomes included graft failure, aortic events, and re\u2010transplant\u2010free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten pediatric MFS patients were identified among 5493 OHT recipients. The median age at OHT was 12.5\u2009years. Over a median follow\u2010up of 3.73\u2009years, no in\u2010hospital mortalities or repeat transplants were observed; two patients experienced rejection, and one developed aortic root dilation without requiring intervention. Propensity\u2010matched analysis showed no significant differences in rejection, aortic events, or transplant\u2010free survival between MFS and non\u2010MFS cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Though rare, pediatric MFS patients undergoing OHT demonstrated excellent short\u2010term outcomes with no MFS\u2010related surgical complications. These findings challenge current exclusionary practices and support further research into long\u2010term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70227","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T04:18:21Z","timestamp":1763353101000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Marfan Syndrome and Heart Transplantation: Insights From the\n                    <scp>PHIS<\/scp>\n                    Database"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2051-276X","authenticated-orcid":false,"given":"Stephanie S.","family":"Philip","sequence":"first","affiliation":[{"name":"Texas Center for Pediatric and Congenital Heart Disease Dell Medical School at the University of Texas at Austin  Austin Texas USA"},{"name":"Department of Pediatrics Dell Medical School at the University of Texas at Austin  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 Medical School at the University of Texas at Austin  Austin Texas USA"},{"name":"Department of Pediatrics Dell Medical School at the University of Texas at Austin  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1694-7894","authenticated-orcid":false,"given":"Matthew F.","family":"Mikulski","sequence":"additional","affiliation":[{"name":"Department of Surgery, Baystate Health UMass Chan Medical School  Springfield Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0725-2791","authenticated-orcid":false,"given":"Andrew","family":"Well","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Division of Pediatric Cardiac Surgery Vanderbilt University School of Medicine  Nashville Tennessee USA"},{"name":"Pediatric Heart Institute Monroe Carell Jr. Childrens Hospital at Vanderbilt  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sagar","family":"Jani","sequence":"additional","affiliation":[{"name":"Texas Center for Pediatric and Congenital Heart Disease Dell Medical School at the University of Texas at Austin  Austin Texas USA"},{"name":"Department of Pediatrics Dell Medical School at the University of Texas at Austin  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Glass","sequence":"additional","affiliation":[{"name":"Texas Center for Pediatric and Congenital Heart Disease Dell Medical School at the University of Texas at Austin  Austin Texas USA"},{"name":"Department of Pediatrics Dell Medical School at the University of Texas at Austin  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles D.","family":"Fraser","sequence":"additional","affiliation":[{"name":"Texas Center for Pediatric and Congenital Heart Disease Dell Medical School at the University of Texas at Austin  Austin Texas USA"},{"name":"Department of Cardiovascular &amp; Thoracic Surgery Dell Medical School at the University of Texas at Austin  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9052-2333","authenticated-orcid":false,"given":"Chesney","family":"Castleberry","sequence":"additional","affiliation":[{"name":"Texas Center for Pediatric and Congenital Heart Disease Dell Medical School at the University of Texas at Austin  Austin Texas USA"},{"name":"Department of Pediatrics Dell Medical School at the University of Texas at Austin  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"volume-title":"StatPearls","year":"2025","author":"Salik I.","key":"e_1_2_9_2_1"},{"key":"e_1_2_9_3_1","unstructured":"NIH \u201cMarfan Syndrome\u2014What Is Marfan Syndrome? 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