{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:40:12Z","timestamp":1792222812646,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute kidney injury (AKI) has been associated with diastolic dysfunction in pre\u2010clinical studies, but with limited evaluation in clinical settings. We sought to examine the association between post\u2010operative AKI and diastolic function after pediatric heart transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010center retrospective review of patients \u2264\u200921years undergoing first\u2010time heart transplantation between May 2010\u2013July 2023. AKI was defined and staged per the KDIGO creatinine criteria, with Stage 2 or 3 classified as severe. Right ventricular end\u2010diastolic pressure (RVEDP) and pulmonary capillary wedge pressure (PCWP) obtained from surveillance cardiac catheterizations in the first two years post\u2010transplant were used to assess diastolic function. Linear mixed\u2010effects models were used to compare hemodynamics between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 101 patients, aged 0\u201320\u2009years, median 4\u2009years (IQR 0\u201313). Pre\u2010transplant diagnosis was congenital heart disease (CHD) in 51 (50%) and cardiomyopathy in 50 (50%) patients. Post\u2010operative AKI occurred in 29 (29%) patients; 16\/29 had severe AKI. AKI was more common in patients with CHD than cardiomyopathy [20\/29 (69%) vs. 9\/29 (31%),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02]. On mixed\u2010effects model analysis adjusting for pre\u2010transplant diagnosis, ischemia time &gt;\u20094\u2009h, and time since transplantation, severe AKI was associated with higher filling pressures over the first 2\u2009years post\u2010transplant, including a 2.2\u2009mmHg increase in RVEDP (95% CI 1.3\u20133.1;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and a 1.8\u2009mmHg increase in PCWP (95% CI 0.8\u20132.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Severe post\u2010transplant AKI was independently associated with higher biventricular filling pressures, suggesting a clinically relevant kidney\u2010heart interaction. Larger studies are needed to further define its mechanistic and clinical implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70503","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:41:51Z","timestamp":1792219311000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post\u2010Operative Acute Kidney Injury After Pediatric Heart Transplantation and Longitudinal Invasive Assessment of Cardiac Filling Pressures"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8682-1325","authenticated-orcid":false,"given":"Faizeen","family":"Zafar","sequence":"first","affiliation":[{"name":"Division of Cardiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7427-670X","authenticated-orcid":false,"given":"Katja M.","family":"Gist","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado Anschutz Medical Campus School of Medicine, Children's Hospital Colorado  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro A.","family":"Floh","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine The Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9404-7368","authenticated-orcid":false,"given":"Nicholas J.","family":"Ollberding","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3672-7960","authenticated-orcid":false,"given":"Dana","family":"Fuhrman","sequence":"additional","affiliation":[{"name":"Divisions of Critical Care Medicine and Nephrology and Hypertension Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7019-809X","authenticated-orcid":false,"given":"Danielle E.","family":"Soranno","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Nephrology Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1053\/j.ajkd.2016.01.024","article-title":"Recovery From Acute Kidney Injury and CKD Following Heart Transplantation in Children, Adolescents, and Young Adults: A Retrospective Cohort Study","volume":"68","author":"Hollander S. 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A.Blair et\u00a0al. \u201cCardiorenal Syndrome: Classification Pathophysiology Diagnosis and Treatment Strategies: A Scientific Statement From the American Heart Association \u201d(2019).","DOI":"10.1161\/CIR.0000000000000664"},{"key":"e_1_2_11_8_1","first-page":"119","article-title":"Acute Kidney Injury Results in Long\u2010Term Diastolic Dysfunction That Is Prevented by Histone Deacetylase Inhibition","volume":"6","author":"Soranno D. E.","year":"2021","journal-title":"JACC: Basic to Translational Science"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1159\/000526010","article-title":"Acute Kidney Injury and Diastolic Dysfunction: Opportunity for Targeted Intervention?","volume":"147","author":"Soranno D. 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