{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:38:59Z","timestamp":1786653539328,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The impact of age at transplantation on the outcomes of pediatric heart\u2013lung transplantation (HLTX) recipients is not well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The UNOS database (1987\u20132023) was retrospectively queried for primary pediatric HLTX in patients \u226418 year of age. The cohort was dichotomized into ages &lt;12 years (Young group [YG]) and \u226512 years (Old group [OG]) due to its impact on the previously used lung allocation score (LAS). The data were extracted for clinic characteristics and outcomes. Standard statistical tests were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      217 (113 YG, 104 OG) patients underwent HTLX. The median age of YG was 4 years, compared to 15 years in OG (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). There was no difference in gender, ethnicity, lung diagnosis, cardiac diagnosis, or blood group. The OG had a higher LAS score but a lower heart listing status. The use of life support (mechanical ventilation, dialysis, and inotrope use) and extracorporeal membrane oxygenation (ECMO) pretransplant was no different. There was a higher donor\/recipient height mismatch in the YG. The HTLX rate has fallen over the decades, especially among the YG. The ischemic times were similar. Posttransplant, prolonged mechanical ventilation was higher in YG, but with lower airway dehiscence, and dialysis, stroke, and rejection incidence were similar in the groups. The 1-year and long-term survival to 17 years was inferior in the YG. On multivariable analysis, only YG and ECMO bridge predicted 1-year mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is a declining trend in HLTX in pediatric patients, with fewer YG patients. The long-term survival of YG was inferior. Recipient age and ECMO bridge were the only independent predictors of mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/apc.apc_7_25","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T17:04:49Z","timestamp":1759856689000},"page":"217-223","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impact on post-transplantation outcomes in pediatric patients undergoing heart\u2013lung transplantation by recipient age at the time of transplantation"],"prefix":"10.4103","volume":"18","author":[{"given":"Sandeep","family":"Sainathan","sequence":"first","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Miami, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Mulinari","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Miami, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"R1-20260420","first-page":"1129","article-title":"Heart-lung transplantation: Pediatric indications and outcomes","volume":"6","author":"Spahr","year":"2014","journal-title":"J Thorac Dis"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/j.athoracsur.2020.08.083","article-title":"Outcome of bridge to lung transplantation with extracorporeal membrane oxygenation in pediatric patients 12 years and older","volume":"112","author":"Sainathan","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"570","DOI":"10.32614\/RJ-2021-053","article-title":"Reproducible summary tables with the gtsummary package","volume":"13","author":"Sjoberg","year":"2021","journal-title":"R J"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.healun.2016.10.007","article-title":"Improved waitlist and transplant outcomes for pediatric lung transplantation after implementation of the lung allocation score","volume":"36","author":"Lancaster","year":"2017","journal-title":"J Heart Lung Transplant"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/ajt.12547","article-title":"The equitable allocation of deceased donor lungs for transplant in children in the United States","volume":"14","author":"Snyder","year":"2014","journal-title":"Am J Transplant"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/j.healun.2019.08.003","article-title":"The international thoracic organ transplant registry of the international society for heart and lung transplantation: Twenty-second pediatric lung and heart-lung transplantation report-2019; Focus theme: Donor and recipient size match","volume":"38","author":"Hayes","year":"2019","journal-title":"J Heart Lung Transplant"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1016\/j.jtcvs.2010.07.087","article-title":"Determinants of outcome after surgical treatment of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries","volume":"140","author":"Carotti","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.jtcvs.2008.12.054","article-title":"Heart-lung transplantation in patients with pulmonary atresia and ventricular septal defect","volume":"138","author":"Januszewska","year":"2009","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R11-20260420","first-page":"376027","article-title":"Heart transplantation in congenital heart disease: In whom to consider and when?","volume":"2013","author":"Attenhofer Jost","year":"2013","journal-title":"J Transplant"},{"key":"R12-20260420","doi-asserted-by":"crossref","first-page":"e12176","DOI":"10.1002\/pul2.12176","article-title":"Efficacy and safety of pulmonary vasodilators in the patients with Eisenmenger syndrome: A meta-analysis of randomized controlled trials","volume":"12","author":"Hou","year":"2022","journal-title":"Pulm Circ"},{"key":"R13-20260420","first-page":"1165","article-title":"Airway complications after lung and heart-lung transplantation","volume":"25","author":"Shumway","year":"1993","journal-title":"Transplant Proc"},{"key":"R14-20260420","first-page":"1207","article-title":"Infection after pediatric heart transplantation: Results of a multiinstitutional study. The pediatric heart transplant study group","volume":"16","author":"Schowengerdt","year":"1997","journal-title":"J Heart Lung Transplant"},{"key":"R15-20260420","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.healun.2013.08.005","article-title":"The registry of the international society for heart and lung transplantation: Sixteenth official pediatric heart transplantation report-2013; focus theme: Age","volume":"32","author":"Dipchand","year":"2013","journal-title":"J Heart Lung Transplant"},{"key":"R16-20260420","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/j.healun.2013.08.008","article-title":"The registry of the international society for heart and lung transplantation: Sixteenth official pediatric lung and heart-lung transplantation report-2013; focus theme: Age","volume":"32","author":"Benden","year":"2013","journal-title":"J Heart Lung Transplant"},{"key":"R17-20260420","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/S1053-2498(03)00305-X","article-title":"Management of aortopulmonary collaterals in children following cardiac transplantation for complex congenital heart disease","volume":"23","author":"Krishnan","year":"2004","journal-title":"J Heart Lung Transplant"}],"container-title":["Annals of Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_7_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:38:58Z","timestamp":1786649938000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_7_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/apc.apc_7_25","relation":{},"ISSN":["0974-2069","0974-5149"],"issn-type":[{"value":"0974-2069","type":"print"},{"value":"0974-5149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"2025-01-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}