Background We sought to examine the influence of various marginal donor criteria on pediatric heart transplantation outcome.
Methods We reviewed the medical records of 236 pediatric heart transplants performed in 213 patients from 1984 through 2006 at UCLA. Recipients were grouped into four (0, 1, 2, and > 3 marginal factors) based on the 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 μg/kg/min, gender mismatch (female donor), age > 34 years, allograft ischemia time > 6 hours, and donor-recipient weight ratio < 0.8 > 2. Study end points were actuarial survival and freedom from rejection. A Cox proportional hazards model was used for statistical analysis.
Results In addition, TCAD-free survival is significantly greater at 3 years for low-risk patients receiving a nonmarginal donor (95 ± 3%) compared with those receiving a donor heart with 2+ marginal factors (70 ± 11%, p value .01). There was no statistical difference in TCAD-free survival among high-risk patients.
Conclusions There was worse outcome associated with patient survival between patients receiving hearts with 3+ marginal factors compared with those receiving 0 marginal factors. In addition, there is a higher incidence of TCAD among low-risk recipients when receiving a heart with 2+ marginal factors.
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