Association of Transplant Rate Ratio, Waitlist Survival, and Post-Transplant Survival: Analysis of Scientific Registry of Transplant Recipients Metrics.

Introduction: We sought to elucidate the relationship between transplant rate ratio, waitlist survival, and 1-y post-transplant survival across liver, lung, and heart transplant programs.

Methods: We extracted the Scientific Registry of Transplant Recipients (SRTR) tier rating data in July 2023 reflecting program performance over the past year in three metrics: transplant rate ratio, waitlist survival, and 1-y post-transplant survival. The five tiers ranged from one (lowest) to five (highest) in terms of performance within each metric. The rating metrics were compared across liver, heart, and lung transplant centers.

Results: A higher transplant rate ratio rating was significantly associated with lower waitlist survival rating among lung transplant centers (r = -0.34, P < 0.01), with a nonsignificant trend observed among heart transplant centers (r = -0.16, P = 0.08). A higher transplant rate ratio rating was associated with higher 1-y post-transplant survival rating among heart transplant centers (r = 0.22, P < 0.05). Although no direct association was found between waitlist survival rating and post-transplant survival rating, the comparison of all three SRTR tier rating metrics simultaneously produced regression planes that were significant for heart and lung transplant centers (P < 0.01 and P = 0.02, respectively). A higher transplant rate ratio rating was significantly associated with lower waitlist survival rating and higher 1-y post-transplant survival rating for these centers, although liver transplant centers exhibited no relationship among these metrics.

Conclusions: Heart and lung transplant centers with higher transplant rate were associated with lower waitlist survival and higher 1-y post-transplant survival, although the SRTR tier ratings were not significantly associated to each other among liver transplant centers.