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Published on: June 26, 2020
Metrics for size-matching in paediatric cardiac transplantation: A narrative review
Griffin P Stinson1, Omar M Sharaf1, Carlos A Valdes1
1Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, FL, USA.
Insights
Selecting the right donor heart size is crucial for pediatric cardiac transplants. This review examines various size-matching metrics to improve transplant outcomes and donor suitability assessments.
Area of Science:
- Cardiology
- Transplantation Surgery
- Pediatric Medicine
Background:
- Donor-recipient size matching is critical in pediatric cardiac transplantation.
- Current size-matching metrics lack consistent evidence and consensus on predictive value for outcomes.
- The donor-to-recipient body weight ratio is the most common metric used.
Purpose of the Study:
- To review and evaluate commonly used size-matching metrics in pediatric cardiac transplantation.
- To assess the predictive value of different metrics for transplant outcomes.
- To inform the selection of optimal size-matching strategies.
Main Methods:
- Systematic review of published literature on size-matching metrics.
- Evaluation of metrics including weight, height, body surface area, and imaging parameters.
- Analysis of metric applicability within the donor assessment timeline.
Main Results:
- Inconsistent evidence exists regarding the superiority of any single size-matching metric.
- Limited consensus on which metric best predicts post-transplant outcomes.
- Donor-to-recipient body weight ratio is widely, but not universally, adopted.
Conclusions:
- Further research is needed to establish a consensus on the optimal size-matching metric.
- Improved metrics could enhance donor heart selection and patient outcomes.
- Standardization of size-matching protocols is essential for pediatric cardiac transplantation.
Abstract:
Several metrics exist for matching the size of donor to recipient in paediatric cardiac transplantation. Different centres employ different metrics for size-matching to determine the viability of donor hearts. Inconsistent evidence exists, with limited consensus as to the metric for size-matching that is most predictive of outcomes after cardiac transplantation. Furthermore, any metric must function within the tight timeline available for the assessment of the suitability of the donor. At the time of the writing of this paper, the most commonly used metric for size-matching in paediatric cardiac transplantation is the donor-to-recipient body weight ratio. In this article, we review published literature evaluating commonly used metrics for size-matching in paediatric cardiac transplantation, including weight, height, body surface area, and imaging parameters.
