The Effect of UNOS Donor Policy Change on Ischemic Time and the Effects on Mortality in Heart Transplantation

A. Lee¹, K. Yang¹, G. Liu¹, C. Lum², A. D. Salimbangon³, R. R. Chand⁴, P. Banankhah¹, P. Genyk¹, P. Kingsford¹, J. Li¹, J. Li¹, D. Vucicevic⁵, K. Pandya¹, J. Rahman¹, M. Fong¹, L. Grazette¹, A. Kiankhooy¹, J. [email protected]¹, S. Hashmi¹, A. Gong¹, J. Pizula¹, D. Miklin¹, S. Shah¹, A. Vaidya¹, A. Wolfson⁶, E. Depasquale¹

¹Keck Medicine of USC, Los Angeles, CA, ²The Queens Medical Center, Honolulu, HI, ³UCLA Medical Center, Los Angeles, CA, ⁴Harbor-UCLA Medical Center, Los Angeles, CA, ⁵Newark Beth-Israel Medical Center, Newark, NJ, ⁶University of Arizona Sarver Heart Center, Tuscon, AZ

Meeting: 2020 American Transplant Congress

Abstract number: B-274

Keywords: Heart, Heart preservation, Heart transplant patients, Heart/lung transplantation

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 ischemic time on mortality.

*Methods: Using the UNOS registry, we compared ischemic time 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 ischemic time less than two hours (p=0.0012), between two to three hours (p=0.0281), and between three to four hours (p <0.001). There was no significant difference with ischemic time greater than four hours.

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

To cite this abstract in AMA style:

Lee A, Yang K, Liu G, Lum C, Salimbangon AD, Chand RR, Banankhah P, Genyk P, Kingsford P, Li J, Li J, Vucicevic D, Pandya K, Rahman J, Fong M, Grazette L, Kiankhooy A, Nattivjonathannattiv@meduscedu J, Hashmi S, Gong A, Pizula J, Miklin D, Shah S, Vaidya A, Wolfson A, Depasquale E. The Effect of UNOS Donor Policy Change on Ischemic Time 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-ischemic-time-and-the-effects-on-mortality-in-heart-transplantation/. Accessed November 21, 2024.

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