Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 24 (1), e13639

Expanding the Donor Pool for Congenital Heart Disease Transplant Candidates by Implementing 3D Imaging-Derived Total Cardiac Volumes


Expanding the Donor Pool for Congenital Heart Disease Transplant Candidates by Implementing 3D Imaging-Derived Total Cardiac Volumes

Svetlana B Shugh et al. Pediatr Transplant.


Background: Heart transplant waitlist mortality remains high in infants <1 year of age and among those with CHD. Currently, the median accepted donor-to-recipient weight percentage is approximately 130% of the recipient's weight. We hypothesized that patients with CHD may accept a larger organ using novel 3D-derived imaging data to estimate donor and recipient TCV.

Methods: A single-center, retrospective study was performed using CT data for 13 patients with CHD and 94 control patients. 3D visualization software was used to create digital 3D heart models that provide an estimate of TCV. In addition, echocardiograms obtained prior to cross-sectional imaging were reviewed for presence of ventricular chamber dilation.

Results: Sixty-two percent (8/13) of patients with CHD had 3D-derived TCV resulting in a weight that was >130% larger than their actual weight. This was seen in single-ventricle patients following Blalock-Taussig shunt and Fontan palliation, and patients with biventricular repair. Of those, 75% (6/8) had reported moderate-to-severe ventricular chamber dilation by echocardiogram or cardiac magnetic resonance imaging.

Conclusions: In a large portion of patients with CHD, 3D-derived TCV place the recipient at a higher listing weight than their actual weight. We propose obtaining cross-sectional imaging to better assess TCV in a recipient, which may increase the donor range for CHD recipients and improve organ utilization in pediatrics.

Keywords: congenital heart disease; imaging; pediatric heart failure; pediatric heart transplantation; size matching.

Similar articles

See all similar articles



    1. Zafar F, Castleberry C, Khan MS, et al. Pediatric heart transplant waiting list mortality in the era of ventricular assist devices. J Heart Lung Transplant. 2015;34(1):82-88.
    1. Davies RR, Bano M, Butts RJ, Jaquiss RDB, Kirk R. Donor organ turn-downs and outcomes after listing for pediatric heart transplant. J Heart Lung Transplant. 2018; 38(3):241-251.
    1. Almond CSD, Thiagarajan RR, Piercey GE, et al. Waiting list mortality among children listed for heart transplantation in the United States. Circulation. 2009;119(5):717-727.
    1. Mah D, Singh TP, Thiagarajan RR, et al. Incidence and Risk Factors for Mortality in Infants Awaiting Heart Transplantation in the USA. J Heart Lung Transplant. 2009;28(12):1292-1298.
    1. McDiarmid SV, Cherikh WS, Sweet SC. Preventable death: Children on the transplant waiting list. Am J Transplant. 2008;8(12):2491-2495.

LinkOut - more resources