Evidence map›Paper›PMID 40088959›Full record

Observational studyThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2025

Reasons for donor heart offer refusal are often unrelated to the donor itself - when, why, and the "weekend effect".

Brian Wayda, Helen Luikart, Yingjie Weng, Shiqi Zhang, Nikole Neidlinger, R Patrick Wood, Javier Nieto, Bruce Nicely, John Belcher, Tahnee Groat and 3 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Brian WaydaDivision of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York.
Helen LuikartDivision of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Yingjie WengQuantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Shiqi ZhangQuantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Nikole NeidlingerDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
R Patrick WoodLifeGift Organ Procurement Organization, Houston, Texas.
Javier NietoLifeGift Organ Procurement Organization, Houston, Texas.
Bruce NicelyGift of Life Michigan, Ann Arbor, Michigan.
John BelcherNew England Donor Services, Waltham, Massachusetts.
Tahnee GroatDepartment of Surgery, Division of Trauma, Critical Care, and Acute Care Surgery, Oregon Health and Science University, Portland, Oregon.
Darren MalinoskiDepartment of Surgery, Division of Trauma, Critical Care, and Acute Care Surgery, Oregon Health and Science University, Portland, Oregon.
Jonathan ZaroffDivision of Research, Kaiser Permanente Northern California, Oakland, California.
Kiran K KhushDivision of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California. Electronic address: kiran@stanford.edu.

Funding

Evidence Based Evaluation and Acceptance of Donor Hearts for TransplantationR01HL125303 · NHLBI · STANFORD UNIVERSITY · PI KHUSH, KIRAN KAUR · 2015 to 2019
$3.0M
Narrowing the gap between supply and demand in heart transplantationF32HL154750 · NHLBI · STANFORD UNIVERSITY · PI WAYDA, BRIAN · 2022 to 2024
$165k
NHLBI NIH HHS F32 HL154750NHLBI NIH HHS R01 HL125303
6 · The paper itself

Abstract

backgroundMost donor hearts offered for heart transplant (HT) in the United States (US) are turned down. We aimed to understand the reasons for this - focusing on those related to the potential recipient and HT center (i.e., donor-unrelated reasons for refusal).

methodsThe Donor Heart Study (DHS) enrolled 4,333 adult potential heart donors in US from 2015 to 2020. Separately by donor, each HT center who refused an offer for that donor was surveyed on their reason(s) for refusal. We measured the prevalences of 18 distinct donor-unrelated reasons for refusal and their association with the timing of offers (weekend vs. weekday).

resultsOur analytic sample included 14,132 unique surveys, each representing a declined offer for one of 3,083 donors (mean per donor: 2.56; range: 1-17). Donor-unrelated reasons were cited in 24.3% (n = 3,441) of surveys; among these, recipient issues (i.e., "recipient ill) were most common (cited in 7%) while resource-related issues (e.g., "logistics", "surgeon unavailable") were rare (<1%). Neither showed a significant time trend; however, other reasons ("already considering another offer", "distance too far") did so, with an abrupt uptick after 2018. We found that several donor-related (but no donor-unrelated) reasons for refusal (e.g., left ventricular hypertrophy, social risk behaviors) were significantly more common on weekends. Their "weekend-predominance" was not explained by differences in objective donor characteristics.

conclusionsNearly one quarter of donor heart offer refusals are due to donor-unrelated reasons. Weekend-predominant reasons for offer refusal signal the highly subjective nature of donor assessment and warrant further scrutiny.

Indexed as

Heart TransplantationTissue and Organ ProcurementTissue DonorsAdultFemaleHumansMaleMiddle AgedTime FactorsUnited Statesclinical decision makingdonor selectionheart transplantationorgan procurementsurvey methodology

Identifiers

PMID40088959
PMCPMC12145243

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.