A Retrospective Analysis of 118 Adult Heart Transplant Centers from 2020 to 2022

Session Number

Project ID: MEDH 34

Advisor(s)

Dr. David Onsager; University of Chicago

Daniel Rodgers; University of Chicago

Dr. Valluvan Jeevanandam; University of Chicago

Discipline

Medical and Health Sciences

Start Date

19-4-2023 10:05 AM

End Date

19-4-2023 10:20 AM

Abstract

The degree of a center’s aggressiveness (Index of Aggression; IA) in procuring organs for transplantation has rarely been quantified. We aim to create a numerical metric that evaluates a center’s IA and seeks to determine the relationship between IA and survival outcomes. We retrospectively analyzed 118 Adult Heart Transplant Centers in the United States between June 2020 to May 2022 using the Scientific Registry of Transplant Recipients (SRTR). The IA of a center was derived from the Donor’s Infectious Risk (IR), Ejection Fraction (EF), Distance from Center (DC), Age, and Offers ( > 50). IA was then calculated by obtaining the mean of all decile ranks for each center, where a value of 1 is the least aggressive and 10 most aggressive. There was no difference in survival observed between IA and survival at 1 year (HR, 0.9733; 95% CI, 0.9787 - 1.14; P = 0.0672) and 3 years (HR, 1.0113; 95% CI, .882-1.034; P=0.254). A higher IA was correlated with reduced 50th percentile wait times (rs = -0.537; 95% CI, 1.01-1.033; P<0.001). The aggression of a center (IA) to pursue a heart is not associated with worse post-transplant survival. In application, a center can maximize their IA without significantly impacting recipient mortality thereby providing quicker therapy that subsequently improves quality of care.

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Apr 19th, 10:05 AM Apr 19th, 10:20 AM

A Retrospective Analysis of 118 Adult Heart Transplant Centers from 2020 to 2022

The degree of a center’s aggressiveness (Index of Aggression; IA) in procuring organs for transplantation has rarely been quantified. We aim to create a numerical metric that evaluates a center’s IA and seeks to determine the relationship between IA and survival outcomes. We retrospectively analyzed 118 Adult Heart Transplant Centers in the United States between June 2020 to May 2022 using the Scientific Registry of Transplant Recipients (SRTR). The IA of a center was derived from the Donor’s Infectious Risk (IR), Ejection Fraction (EF), Distance from Center (DC), Age, and Offers ( > 50). IA was then calculated by obtaining the mean of all decile ranks for each center, where a value of 1 is the least aggressive and 10 most aggressive. There was no difference in survival observed between IA and survival at 1 year (HR, 0.9733; 95% CI, 0.9787 - 1.14; P = 0.0672) and 3 years (HR, 1.0113; 95% CI, .882-1.034; P=0.254). A higher IA was correlated with reduced 50th percentile wait times (rs = -0.537; 95% CI, 1.01-1.033; P<0.001). The aggression of a center (IA) to pursue a heart is not associated with worse post-transplant survival. In application, a center can maximize their IA without significantly impacting recipient mortality thereby providing quicker therapy that subsequently improves quality of care.