Predictors of Donor Heart Utilization in United States.
Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY.
Meeting: 2016 American Transplant Congress
Abstract number: B138
Keywords: Donors, Heart transplant patients, unrelated, Waiting lists
Session Information
Date: Sunday, June 12, 2016
Session Name: Poster Session B: Hearts and VADs in Depth - The Force Awakens
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background
Optimum use of donor organs can increase the reach of the transplant therapy to more patients on waitlist. The heart transplant (HTx) has remained stagnant in United States over last decade at around 2500 HTx annually. Using the United Network of Organ Sharing (UNOS) deceased donor database (DCD) we aimed to evaluate donor factors predicting donor heart utilization.
Methods
UNOS DCD was queried from 2005 to 2014 to identify total number of donors who had at least one of their organs donated. We then generated a multivariate logistic regression model using various demographic and clinical donor factors to predict donor heart use for HTx. Donor hearts not recovered due to consent or family issues or recovered for non-transplant reasons were excluded from the analysis.
Results
During the study period there were 80782 donors of which 23606 (29%) were used for HTx and 38877 (48%) were not used after obtaining consent because of poor organ function (37%), donor medical history (13%) and organ refused by all programs (5%). Of all, 22791 donors with complete data were used for logistic regression (13389 HTx, 9402 no-HTx) which showed significant predictors of donor heart use for HTx [table 1]
| Donor Factors Predicting use of Donor Hearts for Transplant | Odds Ratio | 95% Confidence Lower Limit | 95% Confidence Upper Limit |
| Age | 0.945 | 0.943 | 0.948 |
| Body Mass Index | 1.020 | 1.014 | 1.026 |
| Ejection Fraction | 1.096 | 1.092 | 1.100 |
| Peak Troponin I | 0.998 | 0.997 | 1.000 |
| Bilirubin* | 1.001 | 0.975 | 1.027 |
| Creatinine | 0.927 | 0.906 | 0.949 |
| Diabetes – No | 2.190 | 1.898 | 2.527 |
| Liver Not used of Tx | 0.508 | 0.450 | 0.574 |
| Gender Female | 0.674 | 0.629 | 0.723 |
| Cocaine – No | 1.280 | 1.172 | 1.398 |
| History of MI – No | 2.527 | 1.673 | 3.819 |
| Brain Death Stroke v Tumor | 0.616 | 0.404 | 0.939 |
| Brain Death Anoxia v Tumor | 0.602 | 0.396 | 0.917 |
| Brain Death Head Traum v Tumor* | 1.296 | 0.851 | 1.974 |
| Cardiopulmonary Resuscitation – No* | 0.970 | 0.857 | 1.097 |
| Inotropic Agents – No | 1.627 | 1.245 | 2.126 |
| *Factors Not Signficantly Associated with use of Donor Hearts for Transplant | |||
. Based on model we assigned probability of donor heart use and identified 3070 donors with HTx eligible unused hearts for reasons of poor organ function (28%), organ refused by all programs (15%) and recipient not located (9%).
Conclusion
An objective system based on donor factors can predict donor hearts use for HTx and may help increase availability of hearts for transplant from existing donor pool.
CITATION INFORMATION: Trivedi J, Cheng A, Schumer E, Black M, Massey H, Slaughter M. Predictors of Donor Heart Utilization in United States. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Trivedi J, Cheng A, Schumer E, Black M, Massey H, Slaughter M. Predictors of Donor Heart Utilization in United States. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/predictors-of-donor-heart-utilization-in-united-states/. Accessed November 24, 2020.« Back to 2016 American Transplant Congress