{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T16:12:41Z","timestamp":1769703161867,"version":"3.49.0"},"reference-count":82,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pulmonary hypertension (PH) is a potentially life\u2010threatening disorder characterized by abnormalities of the pulmonary vasculature, causing elevated pulmonary artery pressures, which can result in right ventricular dysfunction. Patients with suprasystemic right ventricular pressure unresponsive to aggressive medical therapy have limited treatment options, including balloon atrial septostomy, reverse Potts shunt, or lung transplantation. The decision to proceed to a palliative reverse Potts shunt or lung transplantation, and the choice of one or the other, depends on surgical, medical, and psychosocial factors. In this manuscript, we discuss the definition, pathophysiology, and current treatments for PH in relation to pediatric lung transplantation, including referral indications and special considerations for transplant candidates. We review the reverse Potts shunt as a palliative option for patients with severe PH, discussing indications, patient outcomes, surgical techniques, and the relative risks\/benefits compared to lung transplantation. Finally, we propose an algorithm to assist pediatric cardiologists, pulmonologists, intensivists, surgeons, and other healthcare providers in the decision\u2010making between a palliative reverse Potts shunt procedure and lung transplantation for patients with severe PH based on currently available data.<\/jats:p>","DOI":"10.1111\/petr.70263","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T09:49:32Z","timestamp":1768384172000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lung Transplantation and Reverse Potts Shunt for Pulmonary Hypertension in the Pediatric Population"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8485-9773","authenticated-orcid":false,"given":"Timothy","family":"Klouda","sequence":"first","affiliation":[{"name":"Division of Pulmonary Medicine Boston Children's Hospital, Hardvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wai","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine Boston Children's Hospital, Hardvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis","family":"Fynn\u2010Thompson","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Boston Children's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse J.","family":"Esch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen B.","family":"Josephson","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine the Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usha S.","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics Columbia University Irving Medical Center Morgan Stanley Children's Hospital of New York Presbyterian  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9635-488X","authenticated-orcid":false,"given":"Levent","family":"Midyat","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Children's Hospital of Pittsburgh University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary P.","family":"Mullen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3046.2002.00217.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.07.84"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2024.01.017"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32597-8"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41030-021-00170-9"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14634"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2016.04.001"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01913-2018"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202206-1180ED"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.03337-2020"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01324-2024"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000329"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.969584"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201406-1052OC"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01916-2018"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1086\/681226"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2011.87"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-010-9849-8"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.008750"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbamcr.2014.01.030"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61621-8"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1542\/pir.2015-0067"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2014.00124"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00140112"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2016.05.011"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00139009"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.9.1197"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.488486"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202410-1901ST"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05304"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25154"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.21037\/cdt-21-65"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14236"},{"issue":"8","key":"e_1_2_10_35_1","first-page":"1129","article-title":"Heart\u2010Lung Transplantation: Pediatric Indications and Outcomes","volume":"6","author":"Spahr J. E.","year":"2014","journal-title":"Journal of Thoracic Disease"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.09.115"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.07.005"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2025.08.004"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2025.08.005"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.05.09"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.17160"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01276.x"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2011.04.009"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.03.025"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.06.141"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsr007"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.5606\/tgkdc.dergisi.2024.25806"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.08.003"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.07.020"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.01.1314"},{"issue":"12","key":"e_1_2_10_51_1","first-page":"2081","article-title":"Survival After Lung Transplantation in Systemic Sclerosis. A Systematic Review","volume":"107","author":"Khan I. Y.","year":"2013","journal-title":"Respirology"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1946.02870460017005"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10153326"},{"issue":"1","key":"e_1_2_10_54_1","first-page":"100","article-title":"Comparison of the Hemodynamics and Survival of Adults With Severe Primary Pulmonary Hypertension or Eisenmenger Syndrome","volume":"15","author":"Hopkins W. E.","year":"1996","journal-title":"Journal of Heart and Lung Transplantation"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.112.000091"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.01.1049"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2017.06.004"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200402053500623"},{"key":"e_1_2_10_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2019.10.149"},{"key":"e_1_2_10_60_1","doi-asserted-by":"publisher","DOI":"10.1177\/0267659120954169"},{"key":"e_1_2_10_61_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu445"},{"key":"e_1_2_10_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.05.039"},{"key":"e_1_2_10_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.11.045"},{"key":"e_1_2_10_64_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045894020958970"},{"key":"e_1_2_10_65_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00072210"},{"key":"e_1_2_10_66_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.077669"},{"key":"e_1_2_10_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.01.004"},{"key":"e_1_2_10_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.10.163"},{"key":"e_1_2_10_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.06.016"},{"key":"e_1_2_10_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.11.045"},{"key":"e_1_2_10_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.01.005"},{"key":"e_1_2_10_72_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002127"},{"key":"e_1_2_10_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.08.078"},{"key":"e_1_2_10_74_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14289"},{"key":"e_1_2_10_75_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12673"},{"key":"e_1_2_10_76_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12683"},{"key":"e_1_2_10_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.01.359"},{"key":"e_1_2_10_78_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-40468-7"},{"key":"e_1_2_10_79_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01193-2024"},{"key":"e_1_2_10_80_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045894020957234"},{"key":"e_1_2_10_81_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0138-2019"},{"key":"e_1_2_10_82_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0139-2020"},{"key":"e_1_2_10_83_1","doi-asserted-by":"publisher","DOI":"10.1161\/circ.148.suppl_1.15889"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70263","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.70263","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70263","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T06:31:02Z","timestamp":1769668262000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":82,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/petr.70263"],"URL":"https:\/\/doi.org\/10.1111\/petr.70263","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2024-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70263"}}