Heart transplant center practice patterns affect access to donors and survival of patients classified as status 1 by the United Network of Organ Sharing.
OBJECTIVE
To determine the effect of adult cardiac transplant center practice patterns within a single organ procurement organization on access to donors and survival for patients listed as United Network of Organ Sharing (UNOS) status 1.


METHODS
A total of 662 patients listed (January 1, 1992, through December 31, 1995) as UNOS status 1 for heart transplantation by the 4 adult cardiac transplant centers in an organ procurement organization were analyzed in a retrospective cohort study to determine differences in clinical outcomes.


RESULTS
The specific center at which an individual was listed as UNOS status 1 was a significant independent predictor of receiving a transplant (odds ratios for 3 centers vs center with highest likelihood = 0.73, 0.64, 0.35, respectively; P <. 01). Only 1 center had a significantly increased mortality rate compared with the other centers (odds ratio 2.03, P <.01).


CONCLUSIONS
Within a single regional organ procurement organization, cardiac transplant centers demonstrate significant variability in the likelihood of transplantation and survival for patients listed as UNOS status 1.
Whellan
D J
DJ
Department of Medicine and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27705, USA. whell001@mc.duke.edu
Tudor
G
G
Denofrio
D
D
Abrams
J D
JD
Loh
E
E
D000328:Adult; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000628:therapy; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D016019:Survival Analysis; D009927:Tissue and Organ Procurement