Great variability in donor heart acceptance practices across the United States
Disparities in organ acceptance practices exacerbate donor heart nonuse and lead to increased waiting times and mortality for heart transplant candidates. We studied disparities in donor heart acceptance among US transplant centers and their relations to posttransplant outcomes. Candidate, potential...
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| Published in | American journal of transplantation Vol. 20; no. 6; pp. 1582 - 1596 |
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| Main Authors | , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Limited
01.06.2020
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1600-6135 1600-6143 1600-6143 |
| DOI | 10.1111/ajt.15760 |
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| Abstract | Disparities in organ acceptance practices exacerbate donor heart nonuse and lead to increased waiting times and mortality for heart transplant candidates. We studied disparities in donor heart acceptance among US transplant centers and their relations to posttransplant outcomes. Candidate, potential transplant recipient match run, and deceased donor data were obtained from the United Network for Organ Sharing. We analyzed donor, candidate, and transplant center characteristics with respect to organ acceptance, offer acceptance, number of offers before acceptance (organ sequence number), and association with posttransplant mortality. A total of 693 420 donor heart offers made between April 2007 and December 2015 were included. We identified great variability in donor heart acceptance practices among US heart transplant centers. We identified donor and recipient characteristics that were strongly associated with heart organ and offer acceptance, and organ sequence number, and identified inconsistencies among centers with respect to how these characteristics influenced acceptance decisions. Finally, we identified characteristics that were highly predictive of donor heart nonuse and were not associated with increased recipient mortality, which may guide future efforts aimed at increasing use of available hearts for transplantation.
In an analysis of 693,420 donor heart offers made in the United States between April 2007 and December 2015, the authors demonstrate great variability in donor heart acceptance practices among transplant centers and identify key opportunities to expand current donor heart utilization. Morris and Vega provide commentary on page 1477. |
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| AbstractList | Disparities in organ acceptance practices exacerbate donor heart nonuse and lead to increased waiting times and mortality for heart transplant candidates. We studied disparities in donor heart acceptance among US transplant centers and their relations to posttransplant outcomes. Candidate, potential transplant recipient match run, and deceased donor data were obtained from the United Network for Organ Sharing. We analyzed donor, candidate, and transplant center characteristics with respect to organ acceptance, offer acceptance, number of offers before acceptance (organ sequence number), and association with posttransplant mortality. A total of 693 420 donor heart offers made between April 2007 and December 2015 were included. We identified great variability in donor heart acceptance practices among US heart transplant centers. We identified donor and recipient characteristics that were strongly associated with heart organ and offer acceptance, and organ sequence number, and identified inconsistencies among centers with respect to how these characteristics influenced acceptance decisions. Finally, we identified characteristics that were highly predictive of donor heart nonuse and were not associated with increased recipient mortality, which may guide future efforts aimed at increasing use of available hearts for transplantation. Disparities in organ acceptance practices exacerbate donor heart nonuse and lead to increased waiting times and mortality for heart transplant candidates. We studied disparities in donor heart acceptance among US transplant centers and their relations to posttransplant outcomes. Candidate, potential transplant recipient match run, and deceased donor data were obtained from the United Network for Organ Sharing. We analyzed donor, candidate, and transplant center characteristics with respect to organ acceptance, offer acceptance, number of offers before acceptance (organ sequence number), and association with posttransplant mortality. A total of 693 420 donor heart offers made between April 2007 and December 2015 were included. We identified great variability in donor heart acceptance practices among US heart transplant centers. We identified donor and recipient characteristics that were strongly associated with heart organ and offer acceptance, and organ sequence number, and identified inconsistencies among centers with respect to how these characteristics influenced acceptance decisions. Finally, we identified characteristics that were highly predictive of donor heart nonuse and were not associated with increased recipient mortality, which may guide future efforts aimed at increasing use of available hearts for transplantation.Disparities in organ acceptance practices exacerbate donor heart nonuse and lead to increased waiting times and mortality for heart transplant candidates. We studied disparities in donor heart acceptance among US transplant centers and their relations to posttransplant outcomes. Candidate, potential transplant recipient match run, and deceased donor data were obtained from the United Network for Organ Sharing. We analyzed donor, candidate, and transplant center characteristics with respect to organ acceptance, offer acceptance, number of offers before acceptance (organ sequence number), and association with posttransplant mortality. A total of 693 420 donor heart offers made between April 2007 and December 2015 were included. We identified great variability in donor heart acceptance practices among US heart transplant centers. We identified donor and recipient characteristics that were strongly associated with heart organ and offer acceptance, and organ sequence number, and identified inconsistencies among centers with respect to how these characteristics influenced acceptance decisions. Finally, we identified characteristics that were highly predictive of donor heart nonuse and were not associated with increased recipient mortality, which may guide future efforts aimed at increasing use of available hearts for transplantation. Disparities in organ acceptance practices exacerbate donor heart nonuse and lead to increased waiting times and mortality for heart transplant candidates. We studied disparities in donor heart acceptance among US transplant centers and their relations to posttransplant outcomes. Candidate, potential transplant recipient match run, and deceased donor data were obtained from the United Network for Organ Sharing. We analyzed donor, candidate, and transplant center characteristics with respect to organ acceptance, offer acceptance, number of offers before acceptance (organ sequence number), and association with posttransplant mortality. A total of 693 420 donor heart offers made between April 2007 and December 2015 were included. We identified great variability in donor heart acceptance practices among US heart transplant centers. We identified donor and recipient characteristics that were strongly associated with heart organ and offer acceptance, and organ sequence number, and identified inconsistencies among centers with respect to how these characteristics influenced acceptance decisions. Finally, we identified characteristics that were highly predictive of donor heart nonuse and were not associated with increased recipient mortality, which may guide future efforts aimed at increasing use of available hearts for transplantation. In an analysis of 693,420 donor heart offers made in the United States between April 2007 and December 2015, the authors demonstrate great variability in donor heart acceptance practices among transplant centers and identify key opportunities to expand current donor heart utilization. Morris and Vega provide commentary on page 1477. Disparities in organ acceptance practices exacerbate donor heart non-use and lead to increased waiting times and mortality for heart transplant candidates. We studied disparities in donor heart acceptance among US transplant centers and their relations to post-transplant outcomes. Candidate, potential transplant recipient match run, and deceased donor data were obtained from the United Network for Organ Sharing. We analyzed donor, candidate, and transplant center characteristics with respect to organ acceptance, offer acceptance, number of offers before acceptance (organ sequence number), and association with post-transplant mortality. A total of 693,420 donor heart offers made between April 2007 and December 2015 were included. We identified great variability in donor heart acceptance practices among US heart transplant centers. We identified donor and recipient characteristics that were strongly associated with heart organ and offer acceptance, and organ sequence number, and identified inconsistencies among centers with respect to how these characteristics influenced acceptance decisions. Finally, we identified characteristics that were highly predictive of donor heart non-use and were not associated with increased recipient mortality, which may guide future efforts aimed at increasing use of available hearts for transplantation. |
| Author | Khush, Kiran K. Ball, Robyn L. |
| AuthorAffiliation | 1 Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California 2 Quantitative Sciences Unit, Department of Medicine, Stanford University, Stanford, California |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31883229$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1111/ajt.14354 10.1111/ctr.12717 10.1016/j.healun.2010.05.034 10.1016/j.athoracsur.2017.03.066 10.1161/CIRCHEARTFAILURE.112.000165 10.1016/j.athoracsur.2016.08.101 10.1016/j.jtcvs.2015.08.081 10.1111/j.2517-6161.1996.tb02080.x 10.1016/j.jtcvs.2009.11.040 10.1111/j.1467-9868.2005.00503.x 10.1111/ajt.13055 10.1053/j.semtcvs.2004.09.007 10.1111/ajt.13030 10.1016/S1053-2498(02)00561-2 10.1155/2014/519401 10.1016/j.healun.2017.10.024 10.1016/j.athoracsur.2003.09.086 10.1111/ajt.14885 10.1016/j.jtcvs.2009.12.006 10.1111/ajt.15278 10.1016/j.healun.2018.04.014 10.18637/jss.v033.i01 10.1016/j.jacc.2017.07.728 10.1198/106186006X133933 |
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| Copyright | 2019 The American Society of Transplantation and the American Society of Transplant Surgeons 2019 The American Society of Transplantation and the American Society of Transplant Surgeons. 2020 The American Society of Transplantation and the American Society of Transplant Surgeons |
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| Keywords | organ acceptance heart transplantation/cardiology clinical research/practice organ procurement and allocation donors and donation |
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| Snippet | Disparities in organ acceptance practices exacerbate donor heart nonuse and lead to increased waiting times and mortality for heart transplant candidates. We... Disparities in organ acceptance practices exacerbate donor heart non-use and lead to increased waiting times and mortality for heart transplant candidates. We... |
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| SubjectTerms | Blood & organ donations clinical research/practice donors and donation Heart Transplantation heart transplantation/cardiology Heart transplants Humans Mortality organ acceptance organ procurement and allocation Tissue and Organ Procurement Tissue Donors Transplant Recipients United States Waiting Lists |
| Title | Great variability in donor heart acceptance practices across the United States |
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