The Effect of UNOS Donor Policy Change on Distance from Recipient Hospital and the Effects on Mortality in Heart Transplantation

P. Kingsford¹, J. P. Li¹, C. J. Lum², A. D. Salimbangon³, G. S. Liu⁴, R. R. Chand⁵, P. Banankhah¹, P. A. Genyk¹, D. Vucicevic¹, K. Pandya¹, J. Rahman¹, M. Fong¹, L. Grazette¹, A. Kiankhooy¹, J. Nattiv¹, S. Hashmi¹, S. B. Nuno¹, J. Pizula¹, D. J. Miklin¹, A. E. Lee¹, K. Yang¹, S. Shah¹, A. S. Vaidya¹, A. M. Wolfson⁶, E. C. DePasquale¹

¹LAC-USC, Los Angeles, CA, ²The Queens Medical Center, Honolulu, HI, ³UCLA Medical Center, Los Angeles, CA, ⁴USC, Los Angeles, CA, ⁵Harbor-UCLA Medical Center, Los Angeles, CA, ⁶University of Arizona Sarver Heart Center, Tucson, AZ

Meeting: 2020 American Transplant Congress

Abstract number: B-273

Keywords: Outcome

Session Information

Session Name: Poster Session B: Heart and VADs: All Topics

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: In light of the recent change in the UNOS allocation policy, we sought to evaluate the impact of distance from recipient hospital on mortality.

*Methods: Using the UNOS registry, we compared distance from recipient hospital in the six months pre-policy change (PRE) and six months post-policy change (POS). Analysis was performed using multivariate Cox proportional hazard regression model that adjusted for age, sex, race, diagnosis of diabetes, recipient wait-time, HLA mismatch, need for dialysis, and need for life support. We excluded patients who were age less than 18 years old or who were lost-to-follow-up. Kaplan-Meier survival analysis was performed.

*Results: 1193 PRE patients and 634 POS patients were identified. After the policy change, patients were more likely to have higher mortality in total distance less than 250 miles (p<0.001) and between 250 and 500 miles (p=0.0281). There was no significant difference in distance greater than 500 miles.

*Conclusions: After the UNOS policy change, shorter distances were associated with higher mortality. Given the paradoxical nature of this conclusion further investigation is needed.

To cite this abstract in AMA style:

Kingsford P, Li JP, Lum CJ, Salimbangon AD, Liu GS, Chand RR, Banankhah P, Genyk PA, Vucicevic D, Pandya K, Rahman J, Fong M, Grazette L, Kiankhooy A, Nattiv J, Hashmi S, Nuno SB, Pizula J, Miklin DJ, Lee AE, Yang K, Shah S, Vaidya AS, Wolfson AM, DePasquale EC. The Effect of UNOS Donor Policy Change on Distance from Recipient Hospital and the Effects on Mortality in Heart Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-effect-of-unos-donor-policy-change-on-distance-from-recipient-hospital-and-the-effects-on-mortality-in-heart-transplantation/. Accessed May 11, 2025.

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