{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:51:12Z","timestamp":1784310672868,"version":"3.55.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2017,3,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There are limited data describing the functional status (FS) of children after heart transplant (HT). We sought to describe the FS of children surviving at least 1 year after HT, to evaluate the impact of HT on FS, and to identify factors associated with abnormal FS post-HT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Organ Procurement and Transplantation Network data were used to identify all US children &lt;21 years of age surviving \u22651 year post-HT from 2005 to 2014 with a functional status score (FSS) available at 3 time points (listing, transplant, \u22651 year post-HT). Logistic regression and generalized estimating equations were used to identify factors associated with abnormal FS (FSS\u22648) post-HT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 1633 children met study criteria. At the 1-year assessment, 64% were \u201cfully active\/no limitations\u201d (FSS=10), 21% had \u201cminor limitations with strenuous activity\u201d (FSS=9); and 15% scored \u22648. In comparison with listing FS, FS at 1 year post-HT increased in 91% and declined\/remained unchanged in 9%. A stepwise regression procedure selected the following variables for association with abnormal FS at 1 year post-HT: \u226518 years of age (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.2\u20132.7), black race (OR, 1.5; 95% CI, 1.1\u20132.0), support with \u2265inotropes at HT (OR, 1.7; 95% CI, 1.2\u20132.5), hospitalization status at HT (OR, 1.5; 95% CI, 1.0\u20132.19), chronic steroid use at HT (OR, 1.5; 95% CI, 1.0\u20132.2), and treatment for early rejection (OR, 2.0; 95% CI, 1.5\u20132.7).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Among US children who survive at least 1 year after HT, FS is excellent for the majority of patients. HT is associated with substantial improvement in FS for most children. Early rejection, older age, black race, chronic steroid use, hemodynamic support at HT, and being hospitalized at HT are associated with abnormal FS post-HT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.115.016520","type":"journal-article","created":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T20:50:39Z","timestamp":1485291039000},"page":"939-950","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Impact of Heart Transplantation on the Functional Status of US Children With End-Stage Heart Failure"],"prefix":"10.1161","volume":"135","author":[{"given":"David M.","family":"Peng","sequence":"first","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulin","family":"Zhang","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Palmon","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Chen","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth D.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhide","family":"Maeda","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth A.","family":"Hollander","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"McDonald","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie B.","family":"Smoot","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Bernstein","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S.","family":"Almond","sequence":"additional","affiliation":[{"name":"From Division of Pediatric Cardiology and The Heart Center Clinical and Translational Research Program, Lucile Packard Children\u2019s Hospital, and the Department of Pediatrics, Stanford University, Palo Alto, CA (D.M.P., D.N.R., S.C., B.D.K., S.A.H., N.M., D.B., C.S.A.); the Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA (Y.Z., M.P.); and Department of Cardiology, Boston Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, MA (L.B.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.08.005"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.106.180449"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.88.2.203"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(97)70270-1"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.07.024"},{"key":"e_1_3_4_7_2","first-page":"191","volume-title":"In: Evaluation of Chemotherapeutic Agents","author":"Karnofsky DA","year":"1949","unstructured":"Karnofsky DA, Burchenal JH. 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