Add like
Add dislike
Add to saved papers

Expanded Criteria Donor Heart Allograft Utilization: National Trends and Outcomes.

BACKGROUND: To examine recent trends in the use of expanded criteria donor organs in heart transplantation, this study assessed center-level variation in acceptance of these allografts and analyzed their posttransplantation outcomes.

METHODS: Adult (aged ≥18 years) heart transplant recipients between 2011 and 2022 were identified in the Organ Procurement and Transplantation Network database. Expanded criteria allografts were defined using a previously validated risk score. After stratifying centers by cumulative transplantation volume, those centers in the top tertile (≥23/year) were considered high volume. Subsequently, the ratio of transplantations using expanded criteria allografts to total transplantations was calculated for each high-volume center. On the basis of tertiles, centers were then categorized as high-, medium-, and low-use centers. The primary outcome was death after transplantation.

RESULTS: Of 23,290 transplantations performed, 5017 (22%) used expanded criteria donor allografts. High-volume heart transplantation centers performed 72% (3628) of these transplantations-1183 (75%) between 2011 and 2014, 1383 (73%) between 2015 and October 2018, and 1062 (68%) between November 2018 and June 2021. Compared with low-volume programs, undergoing expanded criteria heart transplantation at high-volume centers was associated with a significantly reduced hazard of mortality at 1 year (hazard ratio, 0.78; CI, 0.65-0.94; P = .01) and 5 years (hazard ratio, 0.85; CI, 0.75-0.98; P = .02). During the study period, survival rates 1 year after transplantation were similar across high-volume centers, regardless of their use of expanded criteria allografts.

CONCLUSIONS: Undergoing heart transplantation with an expanded criteria donor allograft at a high-volume transplantation center provides a significant survival benefit. Further, the use of more expanded criteria criteria organs, in the right clinical settings, does not negatively affect overall patient outcomes at high-volume centers.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

Related Resources

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app