Evidence map›Paper›PMID 35258159›Full record

ArticlePediatric transplantation2022

Effect of ischemic time on pediatric heart transplantation outcomes: is it the same for all allografts?

Alia Dani, Quyen Vu, Karthik Thangappan, Bin Huang, Samuel Wittekind, Angela Lorts, Clifford Chin, David L S Morales, Farhan Zafar

Open access · greenAbstract read
In one paragraph

Article in Pediatric transplantation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Impact of Primary Diagnosis on the Outcome of Heart Transplantation in Children.Journal of cardiovascular development and disease · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Alia DaniDepartment of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0003-2493-1603
Quyen VuDepartment of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0003-2080-0147
Karthik ThangappanDepartment of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0003-2814-8982
Bin HuangDivision of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0001-9724-675X
Samuel WittekindDivision of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0003-3192-0646
Angela LortsDivision of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0003-1447-5456
Clifford ChinDivision of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0001-5168-456X
David L S MoralesDepartment of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0002-7512-1777
Farhan ZafarDepartment of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0003-1803-7242
Cincinnati Children's Hospital Medical Center · US

Funding

Novel Methods to Grow the Impact of Pediatric Thoracic TransplantationR01HL147957 · NHLBI · CINCINNATI CHILDRENS HOSP MED CTR · PI CHIN, CLIFFORD, MORALES, DAVID L · 2019 to 2022
$2.3M
NHLBI NIH HHS R01 HL147957
6 · The paper itself

Abstract

backgroundStudies have shown that the optimal ischemia time (IT) threshold in pediatric heart transplantation (PHT) is up to 4 h, independent of other donor organ factors. The purpose of this study was to examine the relationship between IT and donor left ventricular ejection fraction (LVEF) and study their impact on PHT outcomes.

methodsThis is a retrospective cohort study of PHT (<18 years) identified in UNOS between January 2000 and March 2020. Post-transplantation survival analysis of patients receiving donor hearts with IT<4, 4-6, and >6 h was performed using Kaplan-Meier curves. Cohort was divided according to donor LVEF median value, and survival was analyzed. Cox regression was performed.

resultsMedian LVEF was 65% in the study cohort (6669 PHT). Overall, IT>6 h was associated with worse survival compared to <4 h regardless of donor LVEF. For allografts with LVEF < 65%, IT = 4-6 h was associated with worse survival compared with IT < 4 h (p = .006) but had similar survival compared with IT > 6 h (p = .315). For allografts with LVEF ≥ 65%, IT = 4-6 h had similar survival compared with <4 h (p = .175) but improved survival compared with >6 h (p = .003). After adjusting for donor and recipient variables, Cox regression showed that IT = 4-6 h was not associated with increased mortality for LVEF ≥ 65%.

conclusionsThe IT threshold of 4 h does not apply to all allografts. Recipients of hearts with LVEF≥65% can tolerate an IT up to 6 h without any detriment to survival. Routine acceptance of these donor hearts could mitigate longer waiting times and poor donor availability for many candidates.

Indexed as

Heart TransplantationAllograftsChildHumansRetrospective StudiesStroke VolumeTissue DonorsVentricular Function, Leftdonor left ventricular ejection fractionischemia timepediatric heart transplantation

Identifiers

PMID35258159
PMCPMC9159355
OpenAlexW4220698103

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.