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Great Variability in Donor Heart Acceptance Practices across the United States. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons Khush, K. K., Ball, R. L. 2019


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.

View details for DOI 10.1111/ajt.15760

View details for PubMedID 31883229