Background We sought to examine the influence of various marginal donor criteria on pediatric heart transplantation outcome.
Methods We reviewed the medical records of 191 pediatric heart transplants performed in 174 patients from 1984 through 2003 at our institution. Recipients were grouped into four (0, 1, 2, and ≥ 3 marginal factors) based on number of donor marginal criteria. A marginal donor allograft was defined by at least one of the following criteria: hx of cardiac arrest, LVEF≤50%, positive hepatitis B or C serology, dopamine ≥ 10 mcg/kg/min, gender mismatch (female donor), age ≥ 34 yr, allograft ischemia time ≥ 6 hours and donor-recipient weight ratio ≤ 0.8 ≥ 2. Study endpoints were actuarial survival and freedom from rejection. A Cox proportional hazards model was used for statistical analysis. (Table)
Conclusions Despite a trend in worse outcome the number of marginal donor criteria did not significantly impact the 1 and 3-year freedom from adverse events in pediatric heart transplantation justifying this strategy to increase the potential donor pool.