Utilization of Public Health Service Increased Risk Donors in Heart Transplantation and Outcomes: UNOS Registry Review

• Published in: The Journal of heart and lung transplantation Vol. 39; no. 4; pp. S271 - S272
• Main Authors: Pandya, K., Rahman, J., Vaidya, A., Fong, M., Grazette, L., Kiankhooy, A., Depasquale, E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2020
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2020.01.594

We aim to evaluate the utilization of Public Health Service (PHS) increased risk donor utilization in heart transplantation (HT) and evaluate outcomes of these patients compared to non-PHS increased risk donors Patients receiving HT from either non PHS increased risk donor or PHS increased risk donor were identified from UNOS registry between years 2005-2019. Exclusion included age <18 years, follow up loss, multi organ transplantation. Survival was censored at 5 years. Multivariate cox proportional hazard regression analysis (adjusted for age, sex, diabetes, ethnicity, ischemic time, dialysis, life support and HLA mismatch) was performed. Only 20% of HT recipients received PHS increased risk donor during the study period. These recipients were older, more likely on life support including LVAD, ventilator, had longer wait times prior to transplantation and more likely to be listed Status 1. Despite of these factors, there is no significant difference in long term survival between the two groups was. It was also notable that in last four years there is consistent increase in utilization of PHS increased risk donors, and these donors accounted for approximately 30% of HT performed in US in year 2018. In recent years, there has been increased utilization of PHS increased risk donors without any significant change in outcomes with HT. Further study is warranted to examine whether this categorization is still warranted.