1. Impact of Center Volume on the Use of Status 2 Exceptions for Heart Transplantation.
- Author
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Thornhill R, Blitzer D, Lirette ST, Carter KT, Mohammed A, Baran DA, and Copeland H
- Subjects
- Humans, Retrospective Studies, Male, Female, Middle Aged, Follow-Up Studies, Prognosis, Adult, Hospitals, High-Volume statistics & numerical data, Waiting Lists, Hospitals, Low-Volume statistics & numerical data, Heart Transplantation statistics & numerical data, Tissue and Organ Procurement statistics & numerical data
- Abstract
Objective: There are limited data examining the relationship between transplant center volume and their use of Status 2 exceptions for heart transplant (OHT)., Methods: A retrospective review of the Organ Procurement and Transplantation Network (OPTN) database identified all patients undergoing OHT under Status 2 exception between late 2018 and early 2023. Demographics were collected and transplant centers were categorized based on the number of OHT performed annually (very low volume = < 5 OHT per year; low volume = 5-24 OHT per year; medium volume = 25-50 OHT per year, high volume = > 50 OHT per year)., Results: Across all centers, 6348 OHT were included, with n = 68 performed at very low volume centers, n = 1001 performed at low volume centers, n = 1834 performed at medium volume centers, and n = 3445 performed at high volume centers. Medium and high volume centers applied for at least one Status 2 exception about 30%-35% of the time, compared to 50%-60% of the time observed at very low and low volume centers. Compared to very low volume centers, medium volume centers applied for half the amount of Status 2 exceptions (IRR = 0.52 [0.35-0.76]; p < 0.001) while high volume centers applied for less than half the amount (IRR = 0.42 [0.29-0.62]; p < 0.001). High-volume centers were also 18% less likely to apply for exceptions than medium-volume centers (IRR = 0.82 [0.74-0.91]; p < 0.001)., Conclusions: Lower volume transplant centers apply for Status 2 exceptions at a significantly higher rate, with a stepwise decrease in exception use with increasing transplant center volume., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2024
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