Risk factors affecting mortality in pediatric heart transplantation: A comprehensive review of pre- and post-transplant contributors
Pediatric heart transplantation (HT) has transformed outcomes for children with end-stage heart failure. Despite advances in surgical techniques and immunosuppressive strategies, mortality remains influenced by numerous risk factors. This review consolidates current literature on pre- and post-trans...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-08-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133425001041 |
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| author | Sydney Elizer, MD Benjamin S. Mantell, MD, PhD, Assistant Professor of Pediatrics |
| author_facet | Sydney Elizer, MD Benjamin S. Mantell, MD, PhD, Assistant Professor of Pediatrics |
| author_sort | Sydney Elizer, MD |
| collection | DOAJ |
| description | Pediatric heart transplantation (HT) has transformed outcomes for children with end-stage heart failure. Despite advances in surgical techniques and immunosuppressive strategies, mortality remains influenced by numerous risk factors. This review consolidates current literature on pre- and post-transplant variables affecting mortality in pediatric HT, focusing on donor, recipient, and environmental contributors. Pertinent adult studies are also incorporated to highlight overlapping considerations. Recognition of these factors is critical to improving graft survival and long-term outcomes. Key pre-transplant elements include repeated sternotomies, high pulmonary vascular resistance, and extremes of body mass index, while post-transplant issues such as infection, rejection, and cardiac allograft vasculopathy (CAV) remain pivotal. Social determinants of health further modulate survival, reflecting the multifaceted nature of pediatric HT outcomes. By synthesizing existing data, this review aims to provide a framework for identifying high-risk profiles in pediatric HT recipients. |
| format | Article |
| id | doaj-art-8025beae7db04e25bcfd23843c42c091 |
| institution | DOAJ |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-8025beae7db04e25bcfd23843c42c0912025-08-20T03:02:59ZengElsevierJHLT Open2950-13342025-08-01910030910.1016/j.jhlto.2025.100309Risk factors affecting mortality in pediatric heart transplantation: A comprehensive review of pre- and post-transplant contributorsSydney Elizer, MD0Benjamin S. Mantell, MD, PhD, Assistant Professor of Pediatrics1Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OhioHeart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Corresponding author: Benjamin S. Mantell, MD, PhD, Advanced Cardiomyopathy Program, The Heart Institute, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229.Pediatric heart transplantation (HT) has transformed outcomes for children with end-stage heart failure. Despite advances in surgical techniques and immunosuppressive strategies, mortality remains influenced by numerous risk factors. This review consolidates current literature on pre- and post-transplant variables affecting mortality in pediatric HT, focusing on donor, recipient, and environmental contributors. Pertinent adult studies are also incorporated to highlight overlapping considerations. Recognition of these factors is critical to improving graft survival and long-term outcomes. Key pre-transplant elements include repeated sternotomies, high pulmonary vascular resistance, and extremes of body mass index, while post-transplant issues such as infection, rejection, and cardiac allograft vasculopathy (CAV) remain pivotal. Social determinants of health further modulate survival, reflecting the multifaceted nature of pediatric HT outcomes. By synthesizing existing data, this review aims to provide a framework for identifying high-risk profiles in pediatric HT recipients.http://www.sciencedirect.com/science/article/pii/S2950133425001041pediatricsheart transplantheart failurecongenital heart diseasecardiomyopathy |
| spellingShingle | Sydney Elizer, MD Benjamin S. Mantell, MD, PhD, Assistant Professor of Pediatrics Risk factors affecting mortality in pediatric heart transplantation: A comprehensive review of pre- and post-transplant contributors JHLT Open pediatrics heart transplant heart failure congenital heart disease cardiomyopathy |
| title | Risk factors affecting mortality in pediatric heart transplantation: A comprehensive review of pre- and post-transplant contributors |
| title_full | Risk factors affecting mortality in pediatric heart transplantation: A comprehensive review of pre- and post-transplant contributors |
| title_fullStr | Risk factors affecting mortality in pediatric heart transplantation: A comprehensive review of pre- and post-transplant contributors |
| title_full_unstemmed | Risk factors affecting mortality in pediatric heart transplantation: A comprehensive review of pre- and post-transplant contributors |
| title_short | Risk factors affecting mortality in pediatric heart transplantation: A comprehensive review of pre- and post-transplant contributors |
| title_sort | risk factors affecting mortality in pediatric heart transplantation a comprehensive review of pre and post transplant contributors |
| topic | pediatrics heart transplant heart failure congenital heart disease cardiomyopathy |
| url | http://www.sciencedirect.com/science/article/pii/S2950133425001041 |
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