title: Multiple listing for pediatric heart transplantation in the U.S.A.: analysis of OPTN registry data from 1995 through 2009.
abstract: Multiple listing is associated with shorter waitlist durations and increased likelihood of transplantation for renal candidates. Little is known about multiple listing in pediatric heart transplantation. We examined the prevalence and outcomes of multiple listing using OPTN data from 1995 through 2009. Characteristics and waitlist outcomes of propensity-score-matched single- and multiple-listed patients were compared. Multiple listing occurred in 23 of 6290 listings (0.4%). Median days between listings was 35 (0-1015) and median duration of multiple listings was 32 days (3-363). Among multiple-listed patients, there were trends toward less ECMO use (0% vs. 11%, p = 0.1) and more frequent requirement for a prospective cross-match (17% vs. 8%, p = 0.08). Multiple-listed patients more commonly had private insurance (78% vs. 56%; p = 0.03). Urgency status at listing was similar between groups (1/1A: 61% vs. 64%, 1B/2: 39 vs. 36%; p = 0.45) as were weight, age, diagnosis, ventilator/inotrope use, and median income (each p ≥ 0.17). There was a trend toward increased incidence of heart transplantation for multiple-listed patients at three, six, and 24 months (50%, 65%, 80%) vs. single-listed patients (40%, 54%, 64%; p = 0.11). Multiple listing for pediatric heart transplantation in the USA occurs infrequently and is more common in patients with private insurance.
authors.affiliation: Pediatric Cardiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA; Clinical and Translational Research, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Feingold
authors.forename: Seo Y
authors.initials: SY
authors.lastname: Park
authors.forename: Diane M
authors.initials: DM
authors.lastname: Comer
authors.forename: Steven A
authors.initials: SA
authors.lastname: Webber
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Bryce
mesh_terms: D000293:Adolescent; D001788:Blood Grouping and Crossmatching; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000628:therapy*; D016027:Heart Transplantation / Q000592:standards*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health; D008297:Male; D015995:Prevalence; D012042:Registries; D012923:Social Class; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000379:methods*; D016896:Treatment Outcome; D014481:United States; D014850:Waiting Lists
keywords: Organ Procurement and Transplantation Network; pediatric heart transplant; socioeconomic factors; waitlist mortality