Heart transplant center practice patterns affect access to donors and survival of patients classified as status 1 by the United Network of Organ Sharing

Am Heart J. 2000 Sep;140(3):443-50. doi: 10.1067/mhj.2000.109214.

Abstract

Objective: To determine the effect of adult cardiac transplant center practice patterns within a single organ procurement organization on access to donors and survival for patients listed as United Network of Organ Sharing (UNOS) status 1.

Methods: A total of 662 patients listed (January 1, 1992, through December 31, 1995) as UNOS status 1 for heart transplantation by the 4 adult cardiac transplant centers in an organ procurement organization were analyzed in a retrospective cohort study to determine differences in clinical outcomes.

Results: The specific center at which an individual was listed as UNOS status 1 was a significant independent predictor of receiving a transplant (odds ratios for 3 centers vs center with highest likelihood = 0.73, 0.64, 0.35, respectively; P <. 01). Only 1 center had a significantly increased mortality rate compared with the other centers (odds ratio 2.03, P <.01).

Conclusion: Within a single regional organ procurement organization, cardiac transplant centers demonstrate significant variability in the likelihood of transplantation and survival for patients listed as UNOS status 1.

MeSH terms

  • Adult
  • Female
  • Health Status*
  • Heart Failure / therapy
  • Heart Transplantation*
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Practice Patterns, Physicians'*
  • Prognosis
  • Survival Analysis
  • Tissue and Organ Procurement*