ArticleTransplant international : official journal of the European Society for Organ Transplantation2026
Elevated filling pressures are associated with poor long-term graft survival after pediatric heart transplantation.
Article in Transplant international : official journal of the European Society for Organ Transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Long-term survival has improved in the current era of pediatric heart transplantation (HT). The impact of elevated filling pressures [EFP; defined as pulmonary capillary wedge pressure (PCWP) > 15 mmHg and/or right atrial pressure (RAP) > 12 mmHg in the absence of biopsy-confirmed rejection] on long-term outcomes beyond 10 years remains poorly characterized. We assessed whether EFP during the early years after HT are associated with poor graft survival and cardiovascular adverse events (AE). We retrospectively analyzed 114 pediatric HT grafts (1986-2020) with available PCWP and/or RAP measurements 7 months to 5 years post-transplant (grouping period), representing a landmark cohort of 5-year survivors. Associations of EFP with graft survival and AE were evaluated. Fourteen grafts (12%) had EFP during the grouping period. Grafts with EFP had significantly worse long-term survival (44% vs. 85% at 10 years; log-rank p < 0.001), and higher risk of graft loss (overall HR 6.04, 95% CI [2.01-16.85]). The incidence of AE was numerically higher in grafts with EFP (26.6 [15.2-43.2] vs. 11.9 [9.4-14.9] per 100 person-years), but should be interpreted as exploratory. EFP within the early years post-transplant are associated with poor graft survival and may indicate cardiovascular complications.
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