Posttransplant outcomes with prolonged donor heart ischemic time in the pediatric population
Bibliographic record
Abstract
Avoiding grafts with ischemic time (IT) >6 hours continues to be advised in pediatric heart transplant (HTx). We sought to evaluate the association between IT and clinical outcomes in a geographically remote center. This was a retrospective single-center analysis of patients transplanted between January 1995 and December 2020. Baseline characteristics and post-HTx outcomes were compared across 3 IT groups (<4.5 hours, 4.5-6 hours, and >6 hours) with results reported in that order. Cox proportional hazard modeling was used to determine factors associated with graft failure. Of the 188 patients, 56.4% were men, the median age was 3.0 years (interquartile range, 0.6, 10.2 years), and 46.3% had congenital heart disease. IT was evenly distributed among the cohort (37.2% vs 31.4% vs 31.4%). There were no differences in early post-HTx morbidity, including primary graft dysfunction (2.9% vs 1.7% vs 5.3%, P = .5). Compared with IT <4.5 hours, longer IT was not associated with graft failure (IT 4.5-6 hours: hazard ratio, 1.10 [0.50-2.39]; P = .810 and [IT >6 hours: hazard ratio 1.10 {0.52-2.35}]; P = .797). In our population, IT was not an independent risk factor for post-HTx morbidity or graft failure. Use of a modified del Nido preservation solution and experience with prolonged IT donors may have contributed to our outcomes.
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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 | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".