AUTHOR=Singh Tajinder P. , Colan Steven D. , Gauvreau Kimberlee 

TITLE=Matching Donor and Recipient Size in Pediatric Heart Transplantation

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10226

DOI=10.3389/ti.2022.10226

ISSN=1432-2277

ABSTRACT=Previous analyses in pediatric heart transplant (HT) recipients using weight or height have not found donor-recipient size-mismatch to be associated with post-transplant mortality. A recent study in 3215 normal US children developed an equation for left ventricular (LV) mass using body surface area (BSA). We assessed whether donor-recipient size match using predicted LV mass (PLM) is associated with post-transplant in-hospital mortality or 1-year graft survival. We identified 4717 children <18 yrs. old who received primary HT in the US during 01/2000 to 03/2015 and divided them into 5 groups (10%, 10%, 60% [reference group], 10% and 10%, respectively) with increasing donor-recipient PLM ratio. In adjusted analysis, group 1 children (PLM ratio ≤0.90) were at higher risk of post-transplant in-hospital mortality (Odds Ratio [OR] 1.55, 95% CI 1.04, 2.31). This association of the most undersized donors with recipient in-hospital mortality was similar when donor-recipient weight ratio<0.88 or BSA ratio<0.92 (lowest decile) were used instead. There was no difference in 1-year graft survival among groups. Utilizing donors with donor-recipient PLM ratio ≤0.90 is associated with higher risk of early post-transplant mortality in pediatric HT recipients. However, this metric is not superior to donor-recipient weight ratio or BSA ratio for assessing size match.