Observational studyThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2025
Reasons for donor heart offer refusal in the United States: Results from 14,132 transplant clinician surveys in the Donor Heart Study.
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. Cited by 2 papers.
What it found
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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.
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.
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Who cites it
2 citing papers in PubMed.
- Donor coronary artery disease and outcomes after heart transplantation: Effect modification by donor age and allocation era.JHLT open · 2026Article
- Orthotopic Heart Transplantation with Concurrent Coronary Artery Bypass Grafting Using In Situ Internal Thoracic Artery.Journal of cardiovascular development and disease · 2026Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundDespite a shortage of donors for heart transplant (HT) in the United States, most potential donor hearts are discarded. We evaluated the reasons why and their temporal and geographic variation using a US-wide survey of HT clinicians.
methodsThe Donor Heart Study enrolled 4,333 adult potential heart donors in United States from 2015-2020. Separately by donor, each HT center that refused an offer for that donor was surveyed on their reason(s) for refusal. We measured the prevalence of 28 distinct donor-unrelated reasons for refusal and characterized their temporal and geographic variation.
resultsOf 14,132 surveys collected-each representing a single declined donor offer-donor-specific, recipient, and mismatch issues were cited in 49.3%, 24.3%, and 38.0%, respectively. Among surveys citing only donor-specific issues, the most common were age, coronary artery disease, left ventricular (LV) systolic dysfunction, and LV hypertrophy; other noncardiac issue(s) (e.g., drug use) were the sole reason in 20.6% of surveys citing only donor-specific issues. Donor age as a reason for offer refusal became increasingly prevalent over time, despite no accompanying change in the prevalence of older (50+ year-old) donors. Reasons for offer refusal varied widely by region, in a manner unexplained by regional differences in objective donor characteristics.
conclusionsOur findings highlight the subjective nature of donor heart assessment. Further scrutiny of non-evidence based reasons for refusal could reduce discard of viable donor hearts.
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