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Outcomes of Heart Transplant Using High Donor Sequence Number Offers
Higher donor sequence numbers (DSNs) might spark provider concern about poor donor quality. We evaluated characteristics of high-DSN offers used for transplant and compared outcomes of high- and low-DSN transplants. Adult isolated heart transplants between January 1, 2015, and December 31, 2022, wer...
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| Published in: | The Journal of surgical research 2024-08, Vol.300, p.325-335 |
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| container_end_page | 335 |
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| container_title | The Journal of surgical research |
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| creator | Zhou, Alice L. Daskam, Maria L. Ruck, Jessica M. Akbar, Armaan F. Larson, Emily L. Casillan, Alfred J. Kilic, Ahmet |
| description | Higher donor sequence numbers (DSNs) might spark provider concern about poor donor quality. We evaluated characteristics of high-DSN offers used for transplant and compared outcomes of high- and low-DSN transplants.
Adult isolated heart transplants between January 1, 2015, and December 31, 2022, were identified from the organ procurement and transplantation network database and stratified into high (≥42) and low ( |
| doi_str_mv | 10.1016/j.jss.2024.05.008 |
| format | article |
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Adult isolated heart transplants between January 1, 2015, and December 31, 2022, were identified from the organ procurement and transplantation network database and stratified into high (≥42) and low (<42) DSN. Postoperative outcomes, including predischarge complications, hospital length of stay, and survival at 1 and 3 y, were evaluated using multivariable regressions.
A total of 21,217 recipients met the inclusion criteria, with 2131 (10.0%) classified as high-DSN. Donor factors associated with greater odds of high-DSN at acceptance included older age, higher creatinine, diabetes, hypertension, and lower left ventricular ejection fraction. Recipients accepting high-DSN offers were older and more likely to be female, of blood type O, and have lower status at transplant. High- and low-DSN transplants had similar likelihood of stroke (3.2% versus 3.5%; P = 0.97), dialysis (12.3% versus 13.5%; P = 0.12), pacemaker implant (2.3% versus 2.1%; P = 0.64), had similar lengths of stay (16 [12-24] versus 16 [12-25] days, P = 0.38), and survival at 1 (91.6% versus 91.6%; aHR 0.85 [0.72-1.02], P = 0.08) and 3 y (84.2% versus 85.1%; aHR 0.91 [0.79-1.05], P = 0.21) post-transplant.
High-DSN (≥42) was not an independent risk factor for post-transplant mortality and should not be the sole deterrent to acceptance. Accepting high-DSN organs may increase access to transplantation for lower-status candidates.</description><identifier>ISSN: 0022-4804</identifier><identifier>ISSN: 1095-8673</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2024.05.008</identifier><identifier>PMID: 38838430</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Donor sequence number ; Female ; Heart transplant ; Heart Transplantation - adverse effects ; Heart Transplantation - statistics & numerical data ; Humans ; Length of Stay - statistics & numerical data ; Male ; Middle Aged ; Outcomes ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Retrospective Studies ; Risk factors ; Tissue and Organ Procurement - statistics & numerical data ; Tissue Donors - statistics & numerical data ; Treatment Outcome</subject><ispartof>The Journal of surgical research, 2024-08, Vol.300, p.325-335</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c235t-b6280940889e4c02ecf967a6ef3abb2ef068d2744de91430171ea1b2dc9f710c3</cites><orcidid>0000-0001-6593-3985</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38838430$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, Alice L.</creatorcontrib><creatorcontrib>Daskam, Maria L.</creatorcontrib><creatorcontrib>Ruck, Jessica M.</creatorcontrib><creatorcontrib>Akbar, Armaan F.</creatorcontrib><creatorcontrib>Larson, Emily L.</creatorcontrib><creatorcontrib>Casillan, Alfred J.</creatorcontrib><creatorcontrib>Kilic, Ahmet</creatorcontrib><title>Outcomes of Heart Transplant Using High Donor Sequence Number Offers</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>Higher donor sequence numbers (DSNs) might spark provider concern about poor donor quality. We evaluated characteristics of high-DSN offers used for transplant and compared outcomes of high- and low-DSN transplants.
Adult isolated heart transplants between January 1, 2015, and December 31, 2022, were identified from the organ procurement and transplantation network database and stratified into high (≥42) and low (<42) DSN. Postoperative outcomes, including predischarge complications, hospital length of stay, and survival at 1 and 3 y, were evaluated using multivariable regressions.
A total of 21,217 recipients met the inclusion criteria, with 2131 (10.0%) classified as high-DSN. Donor factors associated with greater odds of high-DSN at acceptance included older age, higher creatinine, diabetes, hypertension, and lower left ventricular ejection fraction. Recipients accepting high-DSN offers were older and more likely to be female, of blood type O, and have lower status at transplant. High- and low-DSN transplants had similar likelihood of stroke (3.2% versus 3.5%; P = 0.97), dialysis (12.3% versus 13.5%; P = 0.12), pacemaker implant (2.3% versus 2.1%; P = 0.64), had similar lengths of stay (16 [12-24] versus 16 [12-25] days, P = 0.38), and survival at 1 (91.6% versus 91.6%; aHR 0.85 [0.72-1.02], P = 0.08) and 3 y (84.2% versus 85.1%; aHR 0.91 [0.79-1.05], P = 0.21) post-transplant.
High-DSN (≥42) was not an independent risk factor for post-transplant mortality and should not be the sole deterrent to acceptance. Accepting high-DSN organs may increase access to transplantation for lower-status candidates.</description><subject>Adult</subject><subject>Aged</subject><subject>Donor sequence number</subject><subject>Female</subject><subject>Heart transplant</subject><subject>Heart Transplantation - adverse effects</subject><subject>Heart Transplantation - statistics & numerical data</subject><subject>Humans</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Outcomes</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Tissue and Organ Procurement - statistics & numerical data</subject><subject>Tissue Donors - statistics & numerical data</subject><subject>Treatment Outcome</subject><issn>0022-4804</issn><issn>1095-8673</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kD1PwzAURS0EoqXwA1iQR5aEZzsfjpgQBYpU0YF2thLnuaRq4mInSPx7XLUwMllPOvfq-hByzSBmwLK7TbzxPubAkxjSGECekDGDIo1klotTMgbgPEokJCNy4f0Gwl3k4pyMhJRCJgLGZLoYem1b9NQaOsPS9XTpys7vtmXX05VvujWdNesPOrWddfQdPwfsNNK3oa3Q0YUx6PwlOTPl1uPV8Z2Q1fPT8nEWzRcvr48P80hzkfZRlXEJRQJSFpho4KhNkeVlhkaUVcXRQCZrnidJjQUL61jOsGQVr3VhcgZaTMjtoXfnbNjhe9U2XuM2bEU7eCUgS0NeSB5QdkC1s947NGrnmrZ034qB2stTGxXkqb08BakK8kLm5lg_VC3Wf4lfWwG4PwAYPvnVoFNeN3sddeNQ96q2zT_1P-fXfoc</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Zhou, Alice L.</creator><creator>Daskam, Maria L.</creator><creator>Ruck, Jessica M.</creator><creator>Akbar, Armaan F.</creator><creator>Larson, Emily L.</creator><creator>Casillan, Alfred J.</creator><creator>Kilic, Ahmet</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6593-3985</orcidid></search><sort><creationdate>202408</creationdate><title>Outcomes of Heart Transplant Using High Donor Sequence Number Offers</title><author>Zhou, Alice L. ; Daskam, Maria L. ; Ruck, Jessica M. ; Akbar, Armaan F. ; Larson, Emily L. ; Casillan, Alfred J. ; Kilic, Ahmet</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c235t-b6280940889e4c02ecf967a6ef3abb2ef068d2744de91430171ea1b2dc9f710c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Donor sequence number</topic><topic>Female</topic><topic>Heart transplant</topic><topic>Heart Transplantation - adverse effects</topic><topic>Heart Transplantation - statistics & numerical data</topic><topic>Humans</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Outcomes</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Tissue and Organ Procurement - statistics & numerical data</topic><topic>Tissue Donors - statistics & numerical data</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Alice L.</creatorcontrib><creatorcontrib>Daskam, Maria L.</creatorcontrib><creatorcontrib>Ruck, Jessica M.</creatorcontrib><creatorcontrib>Akbar, Armaan F.</creatorcontrib><creatorcontrib>Larson, Emily L.</creatorcontrib><creatorcontrib>Casillan, Alfred J.</creatorcontrib><creatorcontrib>Kilic, Ahmet</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Alice L.</au><au>Daskam, Maria L.</au><au>Ruck, Jessica M.</au><au>Akbar, Armaan F.</au><au>Larson, Emily L.</au><au>Casillan, Alfred J.</au><au>Kilic, Ahmet</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Heart Transplant Using High Donor Sequence Number Offers</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2024-08</date><risdate>2024</risdate><volume>300</volume><spage>325</spage><epage>335</epage><pages>325-335</pages><issn>0022-4804</issn><issn>1095-8673</issn><eissn>1095-8673</eissn><abstract>Higher donor sequence numbers (DSNs) might spark provider concern about poor donor quality. We evaluated characteristics of high-DSN offers used for transplant and compared outcomes of high- and low-DSN transplants.
Adult isolated heart transplants between January 1, 2015, and December 31, 2022, were identified from the organ procurement and transplantation network database and stratified into high (≥42) and low (<42) DSN. Postoperative outcomes, including predischarge complications, hospital length of stay, and survival at 1 and 3 y, were evaluated using multivariable regressions.
A total of 21,217 recipients met the inclusion criteria, with 2131 (10.0%) classified as high-DSN. Donor factors associated with greater odds of high-DSN at acceptance included older age, higher creatinine, diabetes, hypertension, and lower left ventricular ejection fraction. Recipients accepting high-DSN offers were older and more likely to be female, of blood type O, and have lower status at transplant. High- and low-DSN transplants had similar likelihood of stroke (3.2% versus 3.5%; P = 0.97), dialysis (12.3% versus 13.5%; P = 0.12), pacemaker implant (2.3% versus 2.1%; P = 0.64), had similar lengths of stay (16 [12-24] versus 16 [12-25] days, P = 0.38), and survival at 1 (91.6% versus 91.6%; aHR 0.85 [0.72-1.02], P = 0.08) and 3 y (84.2% versus 85.1%; aHR 0.91 [0.79-1.05], P = 0.21) post-transplant.
High-DSN (≥42) was not an independent risk factor for post-transplant mortality and should not be the sole deterrent to acceptance. Accepting high-DSN organs may increase access to transplantation for lower-status candidates.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38838430</pmid><doi>10.1016/j.jss.2024.05.008</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-6593-3985</orcidid></addata></record> |
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| subjects | Adult Aged Donor sequence number Female Heart transplant Heart Transplantation - adverse effects Heart Transplantation - statistics & numerical data Humans Length of Stay - statistics & numerical data Male Middle Aged Outcomes Postoperative Complications - epidemiology Postoperative Complications - etiology Retrospective Studies Risk factors Tissue and Organ Procurement - statistics & numerical data Tissue Donors - statistics & numerical data Treatment Outcome |
| title | Outcomes of Heart Transplant Using High Donor Sequence Number Offers |
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