Clinical course of patients relisted for orthotopic heart transplantation: A national study
Background: The clinical course in patients relisted for heart transplant at a different transplant center is poorly understood. We sought to describe the baseline characteristics, outcomes, and hospital selection of relisted patients by comparing their clinical status at the time of initial and sub...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133424001228 |
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| author | David Rekhtman, BS Amit Iyengar, MD, MSE Nikhil Ganjoo, BA Cindy Song, BA Noah Weingarten, MD Max Shin, MD Michaela Asher, MPhil John DePaolo, MD, PhD Marisa Cevasco, MD, MPH Pavan Atluri, MD |
| author_facet | David Rekhtman, BS Amit Iyengar, MD, MSE Nikhil Ganjoo, BA Cindy Song, BA Noah Weingarten, MD Max Shin, MD Michaela Asher, MPhil John DePaolo, MD, PhD Marisa Cevasco, MD, MPH Pavan Atluri, MD |
| author_sort | David Rekhtman, BS |
| collection | DOAJ |
| description | Background: The clinical course in patients relisted for heart transplant at a different transplant center is poorly understood. We sought to describe the baseline characteristics, outcomes, and hospital selection of relisted patients by comparing their clinical status at the time of initial and subsequent listing. Methods: The United Network for Organ Sharing database was queried for adults listed for first-time isolated heart transplantation between October 18, 2018 and September 30, 2023. Patients delisted from their original transplant center due to relisting at another center were identified. Upon propensity score matching, waitlist and post-transplant outcomes were compared between single-listing and relisted patients. The same characteristics and center volume at the time of initial listing and subsequent relisting were compared. Center quality based on aggregated 1-year mortality was also assessed. Results: Two hundred and seventeen patients were delisted and subsequently relisted. Upon propensity score matching, no significant differences were found between single-listing and relisted patients with regard to waitlist outcomes (all p > 0.05). On subsequent listing, relisted patients had more severe functional limitations (10% vs 23%, p < 0.001), higher status (p < 0.001), and were more likely to be relisted at a higher volume (45% vs 73%, p < 0.001) and better-performing transplant center (p = 0.017). Conclusions: Although waitlist outcomes were similar between single-listing and relisted patients, at the time of relisting, patients were more likely to have severe functional limitations coinciding with higher listing statuses. Further work is needed to determine the underlying motivators for relisting. |
| format | Article |
| id | doaj-art-8b2be5a6a25a4bb594541dbe95fb4ec2 |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-8b2be5a6a25a4bb594541dbe95fb4ec22025-02-09T05:01:55ZengElsevierJHLT Open2950-13342025-02-017100173Clinical course of patients relisted for orthotopic heart transplantation: A national studyDavid Rekhtman, BS0Amit Iyengar, MD, MSE1Nikhil Ganjoo, BA2Cindy Song, BA3Noah Weingarten, MD4Max Shin, MD5Michaela Asher, MPhil6John DePaolo, MD, PhD7Marisa Cevasco, MD, MPH8Pavan Atluri, MD9Perelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PennsylvaniaPerelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaPerelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PennsylvaniaPerelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PennsylvaniaDivision of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Corresponding author: Pavan Atluri, MD, Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, 3400 Spruce St, 6 Silverstein Pavilion, Philadelphia, PA.Background: The clinical course in patients relisted for heart transplant at a different transplant center is poorly understood. We sought to describe the baseline characteristics, outcomes, and hospital selection of relisted patients by comparing their clinical status at the time of initial and subsequent listing. Methods: The United Network for Organ Sharing database was queried for adults listed for first-time isolated heart transplantation between October 18, 2018 and September 30, 2023. Patients delisted from their original transplant center due to relisting at another center were identified. Upon propensity score matching, waitlist and post-transplant outcomes were compared between single-listing and relisted patients. The same characteristics and center volume at the time of initial listing and subsequent relisting were compared. Center quality based on aggregated 1-year mortality was also assessed. Results: Two hundred and seventeen patients were delisted and subsequently relisted. Upon propensity score matching, no significant differences were found between single-listing and relisted patients with regard to waitlist outcomes (all p > 0.05). On subsequent listing, relisted patients had more severe functional limitations (10% vs 23%, p < 0.001), higher status (p < 0.001), and were more likely to be relisted at a higher volume (45% vs 73%, p < 0.001) and better-performing transplant center (p = 0.017). Conclusions: Although waitlist outcomes were similar between single-listing and relisted patients, at the time of relisting, patients were more likely to have severe functional limitations coinciding with higher listing statuses. Further work is needed to determine the underlying motivators for relisting.http://www.sciencedirect.com/science/article/pii/S2950133424001228heart transplantwaiting listrelisting practicesdelisting practicesregionalization |
| spellingShingle | David Rekhtman, BS Amit Iyengar, MD, MSE Nikhil Ganjoo, BA Cindy Song, BA Noah Weingarten, MD Max Shin, MD Michaela Asher, MPhil John DePaolo, MD, PhD Marisa Cevasco, MD, MPH Pavan Atluri, MD Clinical course of patients relisted for orthotopic heart transplantation: A national study JHLT Open heart transplant waiting list relisting practices delisting practices regionalization |
| title | Clinical course of patients relisted for orthotopic heart transplantation: A national study |
| title_full | Clinical course of patients relisted for orthotopic heart transplantation: A national study |
| title_fullStr | Clinical course of patients relisted for orthotopic heart transplantation: A national study |
| title_full_unstemmed | Clinical course of patients relisted for orthotopic heart transplantation: A national study |
| title_short | Clinical course of patients relisted for orthotopic heart transplantation: A national study |
| title_sort | clinical course of patients relisted for orthotopic heart transplantation a national study |
| topic | heart transplant waiting list relisting practices delisting practices regionalization |
| url | http://www.sciencedirect.com/science/article/pii/S2950133424001228 |
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