Patel Anjlee, Bock Matthew J, Wollstein Adi, Nguyen Khanh, Malerba Stefano, Lytrivi Irene D
Division of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Pediatr Transplant. 2016 Aug;20(5):652-7. doi: 10.1111/petr.12734. Epub 2016 Jun 17.
Height matching in pediatric HTx has been proposed as a superior method of evaluating graft size, but no studies have examined survival advantage for height-matched donor-recipient pairs. We hypothesized that in pediatric patients with DCM, an oversized donor improves survival and aimed to define the optimal height ratio in this patient group. Pediatric primary HTx recipients with DCM between 10/89 and 09/12 were identified in the OPTN database. Patients were stratified into three donor-recipient height and weight ratio categories. One- and five-yr survival was compared using Kaplan-Meier analysis and HRs were computed. A total of 2133 children with DCM who underwent HTx during the study period were included. Unadjusted one-yr survival was worse for DRHR <0.87 (HR, 2.15 [95% CL, 1.30, 3.53]; p < 0.01). This difference was not present at five yr post-HTx or when stratified by weight. After adjustment for other risk factors affecting transplant survival, height matching was no longer significant. Although height matching appears to predict short-term survival better than weight in pediatric HTx recipients with DCM, other factors play a more important role as height matching loses significance in multivariate analysis.
儿科心脏移植（HTx）中的身高匹配已被提议作为评估移植物大小的一种更优方法，但尚无研究考察身高匹配的供受者对的生存优势。我们假设，对于患有扩张型心肌病（DCM）的儿科患者，供体过大可提高生存率，并旨在确定该患者群体的最佳身高比。在器官共享联合网络（OPTN）数据库中识别出10/89至09/12期间患有DCM的儿科原发性HTx受者。患者被分为三个供受者身高和体重比类别。使用Kaplan-Meier分析比较1年和5年生存率，并计算风险比（HRs）。共纳入了2133名在研究期间接受HTx的患有DCM的儿童。供受者身高比（DRHR）<0.87时，未经调整的1年生存率较差（HR，2.15 [95%置信区间（CL），1.30，3.53]；p<0.01）。在HTx后5年或按体重分层时，这种差异不存在。在对影响移植生存的其他风险因素进行调整后，身高匹配不再具有显著性。尽管在患有DCM的儿科HTx受者中，身高匹配似乎比体重更能预测短期生存，但在多变量分析中身高匹配失去显著性时，其他因素发挥着更重要的作用。
