{"doi":"10.1111/ctr.15146","title":"Impact of donor‐recipient age‐difference in adolescent heart transplantation","abstract":"INTRODUCTION: The relationship between donor age and adolescent heart transplant outcomes remains incompletely understood. We aimed to explore the effect of donor-recipient age difference on survival after adolescent heart transplantation. METHODS: The United Network for Organ Sharing database was used to identify 2,855 adolescents aged 10-17 years undergoing isolated primary heart transplantation from 1/1/2000 to 12/31/2022. The primary outcome was 10-year post-transplant survival. Multivariable Cox regression identified predictors of mortality after adjusting for donor and recipient characteristics. A restricted cubic spline assessed the non-linear association between donor-recipient age-difference and the adjusted relative mortality hazard. RESULTS: The median donor-recipient age-difference was +3 (range -13 to +47) years, and 17.7% (n = 504) of recipients had an age- difference > 10 years. Recipients with an age-difference > 10 years had a less favorable pre-transplant profile, including a higher incidence of priority status 1A (81.6%, n = 411 vs. 73.6%, n = 1730; p = .01). The 10-year survival rate was 54.6% (95% confidence interval (CI) 48.8- 60.4) among recipients with a donor-recipient age-difference > 10 years and 66.9% (95% CI: 64.4-69.4) among those with an age-difference ≤10 years. An age-difference > 10 years was an independent predictor of mortality (hazard ratio 1.43, 95% CI: 1.18-1.72, p < .001). Spline analysis demonstrated that the adjusted mortality hazard increased with increasingly positive donor-recipient age-difference and became significantly higher at an age-difference of 11 years. CONCLUSION: A donor-recipient age-difference > 11 years is independently associated with higher long-term mortality after adolescent heart transplantation. This finding may help inform acceptable donor selection practice for adolescent heart transplant candidates.","journal":"Clinical Transplantation","year":2023,"id":371696,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9525,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":788827,"name":"Georgina Rowe","orcid":"0000-0003-1098-6881","position":1,"is_corresponding":false},{"id":899587,"name":"M. Mujeeb Zubair","orcid":"0000-0003-4224-0048","position":2,"is_corresponding":false},{"id":859069,"name":"Qiudong Chen","orcid":"0000-0002-2475-4312","position":3,"is_corresponding":false},{"id":1024096,"name":"J. Thomas","orcid":"0000-0001-5433-1831","position":4,"is_corresponding":false},{"id":775942,"name":"Peter Chiu","orcid":"0000-0002-8946-6282","position":5,"is_corresponding":false},{"id":683773,"name":"Asishana A. Osho","orcid":"0000-0002-1140-097X","position":6,"is_corresponding":false},{"id":721714,"name":"Vikram Sood","orcid":"0000-0003-0932-5808","position":7,"is_corresponding":false},{"id":333426,"name":"Kurt R. Schumacher","orcid":"0000-0001-8659-736X","position":8,"is_corresponding":false},{"id":788830,"name":"Dominic Emerson","orcid":"0000-0001-5728-0152","position":9,"is_corresponding":false},{"id":446964,"name":"Michael E. Bowdish","orcid":"0000-0002-0863-2825","position":10,"is_corresponding":false},{"id":510913,"name":"Joanna Chikwe","orcid":null,"position":11,"is_corresponding":false},{"id":658984,"name":"Francis Fynn‐Thompson","orcid":"0000-0003-3488-7394","position":12,"is_corresponding":false},{"id":788828,"name":"George Gill","orcid":"0000-0001-6673-5841","position":0,"is_corresponding":true}],"reference_count":14,"raw_metadata":null,"created_at":"2026-07-19T01:15:49.453761Z","pmid":"37776273","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}