ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2020
Variability in donor organ offer acceptance and lung transplantation survival.
Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Article
- Article
- Article
- Clinical and System-Level Factors Driving Donor Lung Utilization Decisions: A Qualitative Study.Annals of the American Thoracic Society · 2025Article
- Evaluating US Multiple Listing Practices in Lung Transplantation: Unveiling Hidden Disparities.Chest · 2024Article
- A modular simulation framework for organ allocation.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Article
- Lost in Transplantation: Characterizing Racial Gaps in Physician Organ Offer Acceptance.medRxiv : the preprint server for health sciences · 2024Article
- MG53 mitigates warm ischemic lung injury in a murine model of transplantation.The Journal of thoracic and cardiovascular surgery · 2024Article
- Seeing through the Smoke: Clearing Up the Link between Donor Smoke Exposure and Lung Transplant Outcomes.American journal of respiratory and critical care medicine · 2024Article
- Is logistically motivatedFrontiers in transplantation · 2022Article
- Aggressive pursuit and utilization of non-ideal donor lungs does not compromise post-lung transplant survival.Clinical transplantation · 2021Article
- A three-tier system for evaluation of organ procurement organizations' willingness to pursue and utilize nonideal donor lungs.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Dual Procurement of Lung and Heart Allografts Does Not Negatively Affect Lung Transplant Outcomes.The Journal of surgical research · 2021Article
- Lung transplantation during the COVID-19 pandemic: Safely navigating the new "normal".American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2020Article
- Commentary: When simple living-donor lobar transplantation is just not enough.JTCVS techniques · 2020Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundLung transplantation offers a survival benefit for patients with end-stage lung disease. When suitable donors are identified, centers must accept or decline the offer for a matched candidate on their waitlist. The degree to which variability in per-center offer acceptance practices impacts candidate survival is not established. The purpose of this study was to determine the degree of variability in per-center rates of lung transplantation offer acceptance and to ascertain the associated contribution to observed differences in per-center waitlist mortality.
methodsWe performed a retrospective cohort study of candidates waitlisted for lung transplantation in the US using registry data. Logistic regression was fit to assess the relationship of offer acceptance with donor, candidate, and geographic factors. Listing center was evaluated as a fixed effect to determine the adjusted per-center acceptance rate. Competing risks analysis employing the Fine-Gray model was undertaken to establish the relationship between adjusted per-center acceptance and waitlist mortality.
resultsOf 15,847 unique organ offers, 4,735 (29.9%) were accepted for first-ranked candidates. After adjustment for important covariates, transplant centers varied markedly in acceptance rate (9%-67%). Higher cumulative incidence of 1-year waitlist mortality was associated with lower acceptance rate. For every 10% increase in adjusted center acceptance rate, the risk of waitlist mortality decreased by 36.3% (sub-distribution hazard ratio 0.637; 95% confidence interval 0.592-0.685).
conclusionsVariability in center-level behavior represents a modifiable risk factor for waitlist mortality in lung transplantation. Further intervention is needed to standardize center-level offer acceptance practices and minimize waitlist mortality.
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