{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:06:58Z","timestamp":1788858418542,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["413668513"],"award-info":[{"award-number":["413668513"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005971","name":"Deutsche Herzstiftung","doi-asserted-by":"publisher","award":["S\/03\/23"],"award-info":[{"award-number":["S\/03\/23"]}],"id":[{"id":"10.13039\/501100005971","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Heart transplantation is the gold standard therapy for pediatric end\u2010stage heart failure. Ventricular assist devices (VADs) have improved waitlist survival, but their effect on post\u2010transplant outcomes remains uncertain. This study aimed to evaluate the impact of pre\u2010transplant VAD support on outcomes in pediatric heart transplant recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a systematic review and a meta\u2010analysis using three different databases to compare outcomes in pediatric heart transplant recipients with and without pre\u2010transplant VAD support. The primary outcome was long\u2010term survival. Secondary outcomes were postoperative stroke, hospital length of stay (LOS), and post\u2010transplantation rejection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 3247 studies were identified, of which five were included in the analysis. There was no significant difference in long\u2010term survival among patients who survived to transplantation between the groups (HR 0.963; 95% CI 0.84 to 1.10;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.582). However, the postoperative stroke rate was significantly higher in the VAD group (OR 2.17; 95% CI 1.63 to 2.89;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), while no significant differences were observed in hospital LOS (SMD \u22120.09; 95% CI \u22120.33 to 0.14;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.4375) or post\u2010transplant rejection (OR 1.18; 95% CI 1.00 to 1.39;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0505).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre\u2010transplant VAD support was associated with non\u2010inferior survival despite greater baseline severity among patients who survived to transplantation, enabling access to transplantation, but at the cost of higher VAD\u2010related complications, particularly stroke, with no differences in hospital LOS or rejection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70356","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T03:14:18Z","timestamp":1780024458000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Pre\u2010Transplant Ventricular Assist Device Support on Survival After Heart Transplantation in Pediatric Patients: A Systematic Review and Meta\u2010Analysis of Reconstructed Time\u2010To\u2010Event Data"],"prefix":"10.1111","volume":"30","author":[{"given":"Johannes","family":"Fischer","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery Friedrich\u2010Schiller\u2010University Jena  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silas","family":"Schwegmann","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Friedrich\u2010Schiller\u2010University Jena  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Plem","sequence":"additional","affiliation":[{"name":"Department of Neurology Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1815-3095","authenticated-orcid":false,"given":"Ayodeji","family":"Arobo","sequence":"additional","affiliation":[{"name":"College of Health Sciences Obafemi Awolowo University  Ile\u2010Ife Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Almehandi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Science University College London  London 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Cardiology and Congenital Heart Disease Klinikum Stuttgart  Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsvetomir","family":"Loukanov","sequence":"additional","affiliation":[{"name":"Division of Congenital Cardiac Surgery, Department of Cardiac Surgery University Hospital Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5697-2659","authenticated-orcid":false,"given":"Tulio","family":"Caldonazo","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Friedrich\u2010Schiller\u2010University Jena  Jena 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