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Demographic Characteristics of VCA Candidates and Recipients in the U.S.

J. Wainright1, L. Cartwright1, A. Henderson1, W. Cherikh1, S. Booker1, D. Klassen2

1Research, UNOS, Richmond, VA, 2Office of the Chief Medical Officer, UNOS, Richmond, VA

Meeting: 2022 American Transplant Congress

Abstract number: 957

Keywords: Waiting lists

Topic: Basic & Clinical Science » Basic & Clinical Science » 20 - VCA

Session Information

Session Name: VCA

Session Type: Poster Abstract

Date: Sunday, June 5, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: As with other fields of transplantation, it is important to understand the populations VCA transplantation is serving.

*Methods: This study used OPTN VCA waiting list and transplant data from 7/3/14 to 2/28/21 to characterize 98 VCA candidates and 60 VCA recipients – examining sex, race, age, and SES. We also examined waiting list removal patterns.

*Results: Between implementation of the OPTN VCA waiting list on 7/3/14 and 2/28/21, the 98 VCA candidates were 60.2% female, 79.6% white, and 78.6% aged 18-44. Of these, 41 received deceased donor transplants (8 bilateral upper limb, 5 unilateral upper limb, 9 face, 1 face with upper limb, 1 scalp, 1 trachea, 2 abdominal wall, 2 penis, and 12 uterus), and 19 received living donor uterus transplants. An additional 20 candidates were removed for other reasons, including three who died and two who were too sick for transplant. VCA recipients were 63.3% female, 83.3% white, 78.3% aged 18-44, and 45.0% from higher income neighborhoods.

*Conclusions: Demographic characteristics of both candidates and recipients varied greatly by specific VCA type. VCA transplantation serves a wide variety of patient populations. Additional monitoring is needed, however, to understand changes in the field and further investigate access to VCA transplantation.

Characteristics of VCA Candidates on the OPTN VCA Waiting List between 7/3/2014 and 2/28/2021
Upper Limb a Head & Neck b Abdominal Wall Penis Uterus Total
n = 26 n = 16 n = 9 n = 3 n = 43 N=98
Sex
Female 10 (38.5%) 4 (25%) 2 (22.2%) 0 (0%) 43 (100%) 59 (60.2%)
Male 16 (61.5%) 12 (75%) 7 (77.8%) 3 (100%) 0 (0%) 39 (39.8%)
Race
White 20 (76.9%) 13 (81.2%) 5 (55.6%) 3 (100%) 36 (83.7%) 78 (79.6%)
Black 3 (11.5%) 1 (6.2%) 2 (22.2%) 0 (0%) 3 (7%) 9 (9.2%)
Asian 0 (0%) 0 (0%) 0 (0%) 0 (0%) 3 (7%) 3 (3.1%)
Hispanic 3 (11.5%) 2 (12.5%) 1 (11.1%) 0 (0%) 0 (0%) 6 (6.1%)
Native Hawaiian/Pacific Islander 0 (0%) 0 (0%) 1 (11.1%) 0 (0%) 0 (0%) 1 (1.0%)
Multi-racial 0 (0%) 0 (0%) 0 (0%) 0 (0%) 1 (2.3%) 1 (1.0%)
Age
<18 1 (3.8%) 0 (0%) 2 (22.2%) 0 (0%) 0 (0%) 3 (3.1%)
18-34 11 (42.3%) 4 (25%) 2 (22.2%) 1 (33.3%) 37 (86%) 56 (57.1%)
35-44 7 (26.9%) 1 (6.2%) 4 (44.4%) 0 (0%) 6 (14%) 18 (18.4%)
45-54 3 (11.5%) 6 (37.5%) 1 (11.1%) 1 (33.3%) 0 (0%) 11 (11.2%)
55+ 4 (15.4%) 5 (31.2%) 0 (0%) 1 (33.3%) 0 (0%) 10 (10.2%)
Removal Reason
Still waiting 6 (23.1%) 3 (18.8%) 3 (33.3%) 0 (0%) 6 (14.0%) 18 (18.4%)
DD transplant 13 (50%) 11 (68.8%) 2 (22.2%) 2 (66.7%) 12 (27.9%) 41 (41.8%)
LD transplant 0 (0%) 0 (0%) 0 (0%) 0 (0%) 19 (44.2%) 19 (19.4%)
Refused transplant 2 (7.7%) 1 (6.2%) 0 (0%) 0 (0%) 4 (9.3%) 7 (7.1%)
No longer eligible 2 (7.7%) 0 (0%) 0 (0%) 0 (0%) 2 (4.7%) 4 (4.1%)
Cannot contact 2 (7.7%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 2 (2.0%)
Too sick 0 (0%) 0 (0%) 1 (11.1%) 1 (33.3%) 0 (0%) 2 (2.0%)
Died 0 (0%) 1 (6.2%) 2 (22.2%) 0 (0%) 0 (0%) 2 (2.0%)
Condition improved 0 (0%) 0 (0%) 1 (11.1%) 0 (0%) 0 (0%) 1 (1.0%)
Other 1 (3.8%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 2 (2.0%)
a Upper Limb includes unilateral (n=12) and bilateral (n=14).
b Head and Neck includes face (n=12), scalp (n=1), face with scalp (n=2), and trachea (n=1).
Note: Table excludes 1 bilateral upper limb / face candidate to protect patient privacy.
Upper Limb a Head & Neck b Abdominal Wall Penis Uterus Total
n = 13 n = 11 n = 2 n = 2 n = 31 N=60
Sex
Female 4 (30.8%) 3 (27.3%) 0 (0%) 0 (0%) 31 (100%) 38 (63.3%)
Male 9 (69.2%) 8 (72.7%) 2 (100%) 2 (100%) 0 (0%) 22 (36.7%)
Race
White 11 (84.6%) 9 (81.8%) 0 (0%) 2 (100%) 27 (87.1%) 50 (83.3%)
Black 1 (7.7%) 1 (9.1%) 1 (50%) 0 (0%) 1 (3.2%) 4 (6.7%)
Asian 0 (0%) 0 (0%) 0 (0%) 0 (0%) 2 (6.5%) 2 (3.3%)
Hispanic 1 (7.7%) 1 (9.1%) 1 (50%) 0 (0%) 0 (0%) 3 (5.0%)
Multi-racial 0 (0%) 0 (0%) 0 (0%) 0 (0%) 1 (3.2%) 1 (1.7%)
Age
<18 1 (7.7%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 1 (1.7%)
18-34 4 (30.8%) 4 (36.4%) 0 (0%) 1 (50%) 26 (83.9%) 36 (60.0%)
35-44 2 (15.4%) 1 (9.1%) 2 (100%) 0 (0%) 5 (16.1%) 10 (16.7%)
45-54 3 (23.1%) 2 (18.2%) 0 (0%) 0 (0%) 0 (0%) 5 (8.3%)
55+ 3 (23.1%) 4 (36.4%) 0 (0%) 1 (50%) 0 (0%) 8 (13.3%)
Neighborhood Income
Q1: $2,500 – $46,428 0 (0%) 2 (18.2%) 1 (50%) 0 (0%) 6 (19.4%) 9 (15.0%)
Q2: $46,429 – $57,499 2 (15.4%) 2 (18.2%) 1 (50%) 0 (0%) 1 (3.2%) 6 (10.0%)
Q3: $57,500 – $72,227 2 (15.4%) 3 (27.3%) 0 (0%) 0 (0%) 7 (22.6%) 12 (20.0%)
Q4: $72,228 – $243,654 8 (61.5%) 3 (27.3%) 0 (0%) 2 (100%) 14 (45.2%) 27 (45.0%)
Missing 1 (7.7%) 1 (9.1%) 0 (0%) 0 (0%) 3 (9.7%) 6 (10.0%)
Payment Source
Free Care 3 (23.1%) 5 (45.5%) 0 (0%) 1 (50%) 12 (37.5%) 21 (35.5%)
Donation 1 (7.7%) 0 (0%) 0 (0%) 0 (0%) 14 (43.8%) 15 (25.0%)
Private Insurance 1 (7.7%) 2 (18.2%) 0 (0%) 0 (0%) 0 (0%) 3 (5.0%)
Medicaid 1 (7.7%) 1 (9.1%) 1 (50%) 0 (0%) 0 (0%) 3 (5.0%)
Medicare & Choice 0 (0%) 2 (18.2%) 0 (0%) 0 (0%) 0 (0%) 2 (3.3%)
Medicare FFS 1 (7.7%) 0 (0%) 1 (50%) 0 (0%) 0 (0%) 2 (3.3%)
Department of VA 0 (0%) 0 (0%) 0 (0%) 1 (50%) 0 (0%) 1 (1.7%)
Unknown 5 (38.5%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 5 (8.3%)
Missing 1 (7.7%) 1 (9.1%) 0 (0%) 0 (0%) 5 (16.1%) 8 (13.3%)
Diagnosis
Trauma 6 (46.2%) 7 (63.6%) 1 (50%) 1 (50%) 1 (3.2%) 16 (26.7%)
Burns 0 (0%) 2 (18.2%) 0 (0%) 0 (0%) 0 (0%) 3 (5.0%)
Malignancy 0 (0%) 1 (9.1%) 0 (0%) 1 (50%) 0 (0%) 2 (3.3%)
Infection 7 (53.8%) 0 (0%) 1 (50%) 0 (0%) 0 (0%) 8 (13.3%)
Infertility 0 (0%) 0 (0%) 0 (0%) 0 (0%) 30 (96.8%) 30 (50.0%)
Long segment tracheal stenosis 0 (0%) 1 (9.1%) 0 (0%) 0 (0%) 0 (0%) 1 (1.7%)
Days on Waiting List before Transplant
161.0 (66.0-414.0) 342.0 (159.0-395.5) c c 193 (77.3-345.3) d
a Upper Limb includes unilateral (n=5) and bilateral (n=8).
b Head and Neck includes face (n=9), scalp (n=1), and trachea (n=1).
c Cannot be calculated.
d Includes uterus recipients who received deceased donor transplants (n=12).
Note: Table excludes 1 bilateral upper limb / face recipient to protect patient privacy. Missing data reflect data forms not yet submitted.
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To cite this abstract in AMA style:

Wainright J, Cartwright L, Henderson A, Cherikh W, Booker S, Klassen D. Demographic Characteristics of VCA Candidates and Recipients in the U.S. [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/demographic-characteristics-of-vca-candidates-and-recipients-in-the-u-s/. Accessed May 30, 2025.

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