title: Variation of heart transplant rates in the United States during holidays.
abstract: BACKGROUND
  Some cardiac transplant programs may upgrade listed patients to United Network for Organ Sharing (UNOS) 1A-status during the holidays. Whether more transplants actually occur during holidays is unknown.
  
  
  METHODS
  We assessed rates of single-organ heart transplantation from 2001 to 2010 for recipients age ≥18 yr using the UNOS database. Patients were stratified by transplantation during holiday (±3 d, n = 2375) and non-holiday periods (n = 16 112). Holidays included Easter/Spring break, Memorial Day, July 4th, Labor Day, Thanksgiving, and Christmas/New Years (winter holidays). Secondary analysis assessing transplant rates across seasons was also completed.
  
  
  RESULTS
  Donor and recipient characteristics were similar between groups. Compared with non-holidays, July 4th had higher transplant rates (5.69 vs. 5.09 transplants/d, p = 0.03) while the winter holiday had lower transplant rates (4.50 vs. 5.09 transplants/d, p < 0.01). There was a trend toward lower transplant rates for all holidays compared with non-holidays (p = 0.06). Transplant rates were significantly different across seasons with greater rates in spring and summer (p < 0.01).
  
  
  CONCLUSIONS
  Heart transplant rates were higher during the July 4th and lower during the winter holidays. Although there was a higher likelihood of transplantation during the spring and summer seasons, upgrading patients to 1A status during most holidays may not improve their chances for transplantation.
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH.
authors.forename: Justin L
authors.initials: JL
authors.lastname: Grodin
authors.forename: Colby R
authors.initials: CR
authors.lastname: Ayers
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Thibodeau
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Mishkin
authors.forename: Pradeep P A
authors.initials: PP
authors.lastname: Mammen
authors.forename: David W
authors.initials: DW
authors.lastname: Markham
authors.forename: Mark H
authors.initials: MH
authors.lastname: Drazner
authors.forename: Parag C
authors.initials: PC
authors.lastname: Patel
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D006693:Holidays / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D018579:Patient Selection; D011379:Prognosis; D012042:Registries; D012621:Seasons; D015996:Survival Rate; D009927:Tissue and Organ Procurement; D014481:United States
keywords: United Network for Organ Sharing status; heart transplant; holiday; organ donor; organ recipient