ArticleClinical transplantation2025
Effects of Nighttime Procurement and Transplantation on Outcomes Following Heart Transplantation.
Article in Clinical transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Effects of End-ischemic Hypothermic Oxygenated Perfusion on 1-y Graft Function in Kidney Transplantation: A Real-world, Single-center Analysis From the United States.Transplantation direct · 2026Article
- New Perfusion and Preservation Strategies for Donor Hearts.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2026Review
- Clinical Outcomes of Machine Perfusion and Temperature Control Systems in Heart Transplantation: Where We Stand.Journal of clinical medicine · 2025Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study evaluates the effects of nighttime procurement and transplantation on outcomes following heart transplantation.
methodsThe UNOS registry was queried to analyze adult recipients who underwent isolated orthotopic heart transplantation between January 1, 2010, and September 30, 2022. The cohort was stratified into daytime (4 am-8 pm) and nighttime (8 pm-4 am) transplant groups. The primary outcome was 1-year survival. Propensity score-matching was performed. Risk adjustment was performed using multivariable Cox regression. Restricted cubic spline was used to model the association between the time of transplantation and the likelihood of 1-year mortality. Sub-analysis was performed to evaluate the impact of nighttime procurement.
resultsAltogether 30 426 recipients were analyzed, where 10 807 recipients (35.5%) underwent nighttime transplantation. The nighttime recipients had reduced 1-year post-transplant survival compared to the daytime recipients (90.6% vs. 91.5%, p = 0.019), and this lower survival persisted in the propensity score-matched comparison. After adjusting for established predictors for post-transplant mortality, nighttime transplantation continued to have a significantly increased risk of 1-year mortality (hazard ratio [HR] 1.12, 95% confidence interval [CI] 1.03-1.21, p = 0.005). The spline model demonstrated increased odds of 1-year mortality between 5 pm and 4 am, with the highest odds at 11 pm (odds ratio [OR] 1.25, 95% CI 1.07-1.47), compared to the reference transplantation time of 7 am. When assessing the impact of procurement timing, nighttime procurement negatively impacted 1-year post-transplant survival among the daytime recipients.
conclusionThis study demonstrates the adverse impact of nighttime heart procurement and transplantation on early post-transplant survival. With emerging organ perfusion and thermal protection systems, additional studies are warranted to assess the safety of extending the heart preservation period to optimize the timing of transplantation.
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