Kavya Rajesh, Mohamed Hassanein, Sameer Singh, Yanling Zhao, Yuji Kaku, Paul Kurlansky, Farhana Latif, Gabriel Sayer, Nir Uriel, Koji Takeda
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Differences in regional variability of successful transplantation over years since policy change were described.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 8029 patients were included. The cumulative incidence of successful transplant after 30 days was significantly different across regions (<i>p</i> < 0.001). There was no difference in 30-day post-transplant mortality across regions. In each year since the policy change, there continues to be a significant difference in the lowest and highest cumulative incidence of successful transplant at 30 days across regions using difference of difference analysis, suggesting regional variation has not improved over time (<i>p</i> = 0.49).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Since the allocation policy change, there continues to be significant variation in time to successful transplantation across geographic regions.</p>\n </section>\n </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 5","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Geographic Variation Exists in Heart Transplantation for Status One and Two Patients After the 2018 Heart Allocation Policy Change\",\"authors\":\"Kavya Rajesh, Mohamed Hassanein, Sameer Singh, Yanling Zhao, Yuji Kaku, Paul Kurlansky, Farhana Latif, Gabriel Sayer, Nir Uriel, Koji Takeda\",\"doi\":\"10.1111/ctr.70164\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The heart transplant allocation policy change in 2018 was intended to help ameliorate differences in waiting times for heart transplantation across UNOS regions. We sought to examine the regional variability in waitlist times and post-transplant outcomes since these changes were implemented.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The adult patients in the United Network for Organ Sharing registry from October 2018 to December 2022 were included. Regional trends in waitlist time, waitlist events, and post-transplant outcomes were assessed. Differences in regional variability of successful transplantation over years since policy change were described.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 8029 patients were included. The cumulative incidence of successful transplant after 30 days was significantly different across regions (<i>p</i> < 0.001). There was no difference in 30-day post-transplant mortality across regions. In each year since the policy change, there continues to be a significant difference in the lowest and highest cumulative incidence of successful transplant at 30 days across regions using difference of difference analysis, suggesting regional variation has not improved over time (<i>p</i> = 0.49).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Since the allocation policy change, there continues to be significant variation in time to successful transplantation across geographic regions.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10467,\"journal\":{\"name\":\"Clinical Transplantation\",\"volume\":\"39 5\",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-04-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Transplantation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/ctr.70164\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Transplantation","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ctr.70164","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Geographic Variation Exists in Heart Transplantation for Status One and Two Patients After the 2018 Heart Allocation Policy Change
Background
The heart transplant allocation policy change in 2018 was intended to help ameliorate differences in waiting times for heart transplantation across UNOS regions. We sought to examine the regional variability in waitlist times and post-transplant outcomes since these changes were implemented.
Methods
The adult patients in the United Network for Organ Sharing registry from October 2018 to December 2022 were included. Regional trends in waitlist time, waitlist events, and post-transplant outcomes were assessed. Differences in regional variability of successful transplantation over years since policy change were described.
Results
A total of 8029 patients were included. The cumulative incidence of successful transplant after 30 days was significantly different across regions (p < 0.001). There was no difference in 30-day post-transplant mortality across regions. In each year since the policy change, there continues to be a significant difference in the lowest and highest cumulative incidence of successful transplant at 30 days across regions using difference of difference analysis, suggesting regional variation has not improved over time (p = 0.49).
Conclusions
Since the allocation policy change, there continues to be significant variation in time to successful transplantation across geographic regions.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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