Conclusions
In this study of 85,505 donor heart offers across the United States to
133 different centers, 15,264 (17.9%) resulted in acceptance for OHT.
Centers range considerably with regards to donor heart acceptance rates.
In centers with higher acceptance rates, there was a higher utilization
of ECDs, yet one- and five-year posttransplant survival were comparable
to less aggressive transplanting centers. Additionally, of the five ECD
factors, only donor age >40 years was associated with
higher risk for posttransplant mortality. This data suggests that
transplanting centers, regardless of aggressiveness and clinical volume,
can safely utilize ECDs with the other four risk factors (LVEF
<60%, >500-mile distance, >50
previous offers, and HIV, HCV, or HBV positive) and achieve comparable
posttransplant outcomes. Expansion of these donor criteria may help
alleviate the relative organ shortage in the wake of an increasing heart
failure population. Furthermore, a more in-depth understanding of donor
acceptance practices in more aggressive centers with possible education
and transfer of these practices to less aggressive centers may yield
more OHTs nationally without an adverse impact on outcomes.
Acknowledgements
None