Evidence map›Paper›PMID 42717645›Full record

ArticleClinical transplantation2026

Donor Right Ventricular Oversizing Is Independently Associated With Severe Primary Graft Dysfunction After Heart Transplantation: A Multicenter Retrospective Analysis.

Awab Ahmad, Chen Chia Wang, Mark Petrovic, Aaron M Williams, John Trahanas, Swaroop Bommareddi, Tarek Absi, Eric Quintana, Kevin McGann, Abhirami Thaivalappil and 15 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical 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.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

25 authors.

Awab AhmadDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Chen Chia WangSchool of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Mark PetrovicSchool of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Aaron M WilliamsDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
John TrahanasDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Swaroop BommareddiDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Tarek AbsiDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Eric QuintanaDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Kevin McGannDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Abhirami ThaivalappilSchool of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Christian EidsonSchool of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Walter NavidSchool of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Hasan SiddiqiDepartment of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Marshall BrinkleyDepartment of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Stacy TsaiDepartment of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Aniket S RaliDepartment of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Jonathan N MenachemDepartment of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Dawn PedrottyDepartment of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Suzanne SacksDepartment of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Sandip ZalawadiyaDepartment of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Matthew BacchettaDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
JoAnn LindenfeldDepartment of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Kelly SchlendorfDepartment of Cardiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Ashish S ShahDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Brian LimaDepartment of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007347 · NIGMS · VANDERBILT UNIVERSITY · PI WILLIAMS, CHRISTOPHER S. · 1985 to 2023
$26.3M
NIGMS NIH HHS T32 GM007347NIGMS of National Institutes of Health T32GM007347the American Heart Association 24PRE1187121Vanderbilt University Medical Center David M. Livingston Lung Transplant Memorial Fund, Cystic Fibrosis Foundation VUNJAK23XX0Vanderbilt University Medical Center Mrs. Shelley F. Kleiner and Dr. Fredric Kleiner FundVanderbilt University Medical Center Ms. Dorothy Thomas Research Fund, Congressionally Directed Medical Research Programs DARPA N660012424024Vanderbilt University Medical Center Ms. Dorothy Thomas Research Fund, Congressionally Directed Medical Research Programs PR212237
6 · The paper itself

Abstract

backgroundPredicted heart mass (PHM) is widely used for donor-recipient size matching in heart transplantation, yet its relevance to early graft performance in the modern allocation era remains uncertain. Emerging data suggest that left and right ventricular mismatch may exert distinct physiologic effects that are obscured by total PHM.

methodsWe performed a multicenter retrospective cohort study of adult heart transplant recipients in the UNOS database from September 2023 to June 2025. Donor-recipient mismatch was calculated for total PHM and separately for LV and RV predicted mass. The primary outcome was severe PGD within 24 h.

resultsAmong 5,270 recipients, 387 (7.3%) developed severe PGD. Total PHM mismatch was not associated with PGD (global p = 0.39). In contrast, RV oversizing demonstrated a significant, nonlinear association with PGD (global p = 0.01), with increased risk emerging at approximately +15% RV oversizing. LV mismatch showed a weaker association, with elevated risk only at extreme undersizing. Separating PHM into ventricular-specific components significantly improved risk classification compared with total PHM (overall NRI 18.9%; 95% CI, 15.4%-21.4%). A ventricular asymmetry phenotype characterized by concurrent LV undersizing and RV oversizing, though uncommon, was associated with markedly higher PGD risk (adjusted OR 2.79; 95% CI, 1.46-5.33). No effect modification by pulmonary vascular resistance was observed.

conclusionsVentricular-specific sizing, particularly RV mismatch, provides superior discrimination for severe PGD and highlights RV oversizing as an underrecognized contributor to early allograft failure. These findings support a shift toward biventricular, donor-recipient matching.

Indexed as

Graft RejectionHeart TransplantationHeart VentriclesPostoperative ComplicationsPrimary Graft DysfunctionTissue DonorsAdultFemaleFollow-Up StudiesGraft SurvivalHumansMaleMiddle AgedPrognosisRetrospective StudiesRisk Factorsdonor recipient sizingECMOheart transplantpredicted heart massprimary graft dysfunctionsize mismatch

Identifiers

PMID42717645
PMCPMC13559201

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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.