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L ung transplantation (LTx) faces a suboptimal organ allocation scheme, with long waiting times and high waiting list mortality for transplant candidates. Although the lung allocation score (LAS) stratifies recipient risk and contributes to lowering waiting time, mortality remains 15% for adult and 22% for pediatric patients awaiting LTx. 1 On the other hand, only 20% of all multiorgan donors are utilized for LTx in the United States, compared with 50% in European countries. 2,3 An important factor contributing to the apparent shortage of organs in the United States is the usage of nonstandardized and often stringent donor selection criteria: Over 15 different characteristics that vary between centers are considered while selecting donors. 4 The role of each of these characteristics and their combined effect is largely unknown. Other solid organ transplant groups have successfully devised comprehensive donor risk stratification systems based on the combined impact of these characteristics to standardize their matching process. 5 For example, the kidney donor profile index, adapted by the United Network for Organ Sharing (UNOS) in 2014, resulted in increased utilization of organs, and

A 16-year-old with new-onset dilated cardiomyopathy underwent VAD placement, later complicated by low flow from outflow graft kinking. To expedite heart transplantation, TCV was calculated and compared with 141 normal patients pinpointing the upper weight threshold. He was transplanted 2 days later within the expanded weight range with no post-transplant complications.

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CTFR modulator treatment for a larger proportion of PwCF. Early evidence with ivacaftor therapy found a positive impact on FEV1 decline, 2 thus, preserving higher pulmonary function for a longer time period. A population-based study found that ivacaftor seemed to decrease mortality risk and possibly reduced the need for the solid organ transplant in PwCF, 3 but this study was limited by a small

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Background Mechanical ventilation prior to pediatric heart transplantation predicts inferior post‐transplant survival, but the impact of ventilation duration on survival is unclear. Methods Data from the United Network for Organ Sharing and Pediatric Health Information System were used to identify pediatric (<18 years) heart transplant recipients from 2003 to 2020. Patients ventilated pretransplant were first compared to no ventilation, then ventilation durations were compared across quartiles of ventilation (≤1 week, 8 days–5 weeks, >5 weeks). Results At transplant, 11% (511/4506) of patients required ventilation. Ventilated patients were younger, had more congenital heart disease, more urgent listing‐status, and greater rates of nephropathy, TPN‐dependence, and inotrope and ECMO requirements (p < .001 for all). Post‐transplant, previously ventilated patients experienced longer ventilation durations, ICU and hospital stays, and inferior survival (all p < .001). Hospital outcomes and survival worsened with longer pretransplant ventilation. One‐year and overall survival were similar between the no‐ventilation and ≤1 week groups (p = .703 & p = .433, respectively) but were significantly worse for ventilation durations >1 week (p < .001). On multivariable analysis, ventilation ≤1 week did not predict mortality (HR 0.98 [95% CI 0.85–1.43]), whereas ventilation >1 week did (HR: 1.18 [1.01–1.39]). Conclusions Longer pretransplant ventilation portends worse outcomes, although only ventilation >1 week predicts mortality. These findings can inform pretransplant prognostication.