Faculty Collaboration Database

Risk and Reward: Nationwide Analysis of Cardiac Transplant Center Variation in Organ Travel Distance and the Effects on Outcomes. Clin Transplant 2024 Sep;38(9):e15456

Date

09/04/2024

Pubmed ID

39229694

DOI

10.1111/ctr.15456

Scopus ID

2-s2.0-85203181690 (requires institutional sign-in at Scopus site)

Abstract

BACKGROUND: The 2018 UNOS allocation policy change deprioritized geographic boundaries to organ distribution, and the effects of this change have been widespread. The aim of this investigation was to analyze changes in donor transplant center distance for organ travel and corresponding outcomes before and after the allocation policy change.

METHODS: The UNOS database was utilized to identify all adult patients waitlisted for heart transplants from 2016 to 2021. Transplant centers were grouped by average donor heart travel distance based on whether they received more or less than 50% of organs from >250 miles away. Descriptive statistics were provided for waitlisted and transplanted patients. Regression analyses modeled waitlist mortality, incidence of transplant, overall survival, and graft survival.

RESULTS: Centers with a longer average travel distance had a higher mean annual transplant volume with a reduction in total days on a waitlist (86.6 vs. 149.2 days), an increased cold ischemic time (3.6 vs. 3.2 h), with no significant difference in post-transplant overall survival or graft survival.

CONCLUSIONS: The benefits of reducing waitlist time while preserving post-transplant outcomes extend broadly. The trends observed in this investigation will be useful as we revise organ transplant policy in the era of new organ procurement and preservation techniques.

Author List

Seadler BD, Karra H, Zelten J, Rein LE, Durham LA, Joyce LD, Kohmoto T, Joyce DL

Authors

Lucian A. Durham MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
Takushi Kohmoto MD, PhD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Female
Follow-Up Studies
Graft Survival
Heart Transplantation
Humans
Male
Middle Aged
Prognosis
Risk Factors
Survival Rate
Tissue Donors
Tissue and Organ Procurement
Travel
United States
Waiting Lists