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The Journal of Heart and Lung Transplantation
International Society for Heart and Lung Transplantation.

Pediatric heart transplant using hearts from oversized donors

  • Tajinder P. Singh
    Correspondence
    Reprint requests T. P. Singh, MD, MSc, Department of Cardiology, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115. Telephone: 617-355-0558. Fax: 617-734-9930
    Affiliations
    Department of Cardiology, Boston Children's Hospital, Boston, MA

    Department of Pediatrics, Harvard Medical School, Boston, MA
    Search for articles by this author
      Transplant centers are expected to provide an acceptable range for donor weight when listing a candidate for heart transplant (HT). This range is usually 80% to 200% of the recipient weight in pediatric recipients. The upper limit is an estimate up to which a heart from an oversized donor can be accommodated in a recipient's mediastinum, considering the presence of cardiomegaly in many children with heart failure. In a recent analysis of 4,217 US children <18 years old who underwent primary HT during 2000-2015, recipients of a heart from an oversized donor were not at increased risk of in-hospital or 1-year mortality.
      • Singh TP
      • Colan SD
      • Gauvreau K.
      Matching donor and recipient size in pediatric heart transplantation.
      Interestingly, donor-recipient (DR) weight ratio was >2.0 in 7.5% of recipients, suggesting significant center variability for acceptable upper limit for donor weight. The 2022 pediatric report of the International Thoracic Organ Transplant Registry further confirms this center variability by finding that DR weight ratio was >2.0 in 20% of infant HT recipients; DR weight ratio was not associated with 1-year post-transplant survival.
      • Singh TP
      • Cherikh WS
      • Hsich E
      • et al.
      The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Twenty-fifth pediatric heart transplantation report - 2022; focus on infant heart transplantation.
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      References

        • Singh TP
        • Colan SD
        • Gauvreau K.
        Matching donor and recipient size in pediatric heart transplantation.
        Transpl Int. 2022; 35: 10226
        • Singh TP
        • Cherikh WS
        • Hsich E
        • et al.
        The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Twenty-fifth pediatric heart transplantation report - 2022; focus on infant heart transplantation.
        J Heart Lung Transplant. 2022; 41
        • Szugye NA
        • Moore RA
        • Dani A.
        Comparing donor and recipient total cardiac volume predicts risk of short-term adverse outcomes following heart transplantation.
        J Heart Lung Transplant. 2022; 41