CARD15: Parent Perceptions of Ex-Situ Heart Perfusion
Bibliographic record
Abstract
Introduction: Pediatric heart transplant (HTx) candidates continue to have high waitlist mortality due to donor availability. Ex-situ heart perfusion (ESHP) has the potential to increase the donor pool, yet has been used sparingly in pediatrics due to size restrictions of the current technology. Previous work has shown that for ESHP to be accepted by pediatric healthcare providers (HCP), the risks to the donor heart and the costs need to be better understood and that rigorous research and implementation oversight is essential. Perspectives from caregivers about ESHP has not been assessed and forms the basis of this qualitative study. Methods: Virtual, semi-structured interviews were conducted with caregivers of children who are awaiting or received HTx. Data were analyzed using qualitative content analysis. Results: Twelve participants from 2 countries participated in this study. Awareness about and understanding of ESHP varied among participants from complete unawareness to understanding specifics. Independent of their awareness, all purported that it was an excellent and innovative technology, and supported ESHP implementation in pediatrics. No ethical issues or concerns about the use were identified that differed from other medical technologies, although participants did state that understanding the length of time the heart can be mounted and risks to donor and recipient were important. Participants expressed various views on how to approach parents regarding ESHP. Overall, most participants stated that the consent processes should be like other medical procedure and some commented that deferred or waived consent would be acceptable, especially if ESHP became part of routine clinical practice. Even if consent was waived, participants agreed that the use of ESHP should be disclosed just like other information is disclosed about the donor heart and that introduction of ESHP should come early in the HTx journey. Conclusion: Families are supportive of the use of ESHP. Like HCPs, they endorse the need to understand the potential risks and that information should be presented early in the transplant process.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.025 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".