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Heart and lung organ offer acceptance practices of transplant programs are associated with waitlist mortality and organ yield
- Source :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 18(8)
- Publication Year :
- 2017
-
Abstract
- Variation in heart and lung offer acceptance practices may affect numbers of transplanted organs and create variability in waitlist mortality. To investigate these issues, offer acceptance ratios, or adjusted odds ratios, for heart and lung transplant programs individually and for all programs within donation service areas (DSAs) were estimated using offers from donors recovered July 1, 2016-June 30, 2017. Logistic regressions estimated the association of DSA-level offer acceptance ratios with donor yield and local placement of organs recovered in the DSA. Competing risk methodology estimated the association of program-level offer acceptance ratios with incidence and rate of waitlist removals due to death or becoming too sick to undergo transplant. Higher DSA-level offer acceptance was associated with higher yield (odds ratios [ORs]: lung, (1.04)1.11(1.19); heart, (1.09)1.21(1.35)) and more local placement of transplanted organs (ORs: lung, (1.01)1.12(1.24); heart, (1.47)1.69(1.93)). Higher program-level offer acceptance was associated with lower incidence of waitlist removal due to death or becoming too sick to undergo transplant (hazard ratios [HRs]: heart, (0.80)0.86(0.93); lung, (0.67)0.75(0.83)), but not with rate of waitlist removal (HRs: heart, (0.91)0.98(1.06); lung, (0.89)0.99(1.10)). Heart and lung offer acceptance practices affected numbers of transplanted organs and contributed to program-level variability in the probability of waitlist mortality.
- Subjects :
- Male
medicine.medical_specialty
Tissue and Organ Procurement
Waiting Lists
030230 surgery
Logistic regression
Article
Resource Allocation
03 medical and health sciences
0302 clinical medicine
medicine
Immunology and Allergy
Humans
Pharmacology (medical)
Transplantation
Lung
business.industry
Incidence (epidemiology)
Hazard ratio
Odds ratio
Middle Aged
Patient Acceptance of Health Care
Prognosis
Tissue Donors
Survival Rate
medicine.anatomical_structure
Donation
Transplanted Organs
Emergency medicine
Heart Transplantation
030211 gastroenterology & hepatology
Female
Waitlist mortality
business
Follow-Up Studies
Lung Transplantation
Subjects
Details
- ISSN :
- 16006143
- Volume :
- 18
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Accession number :
- edsair.doi.dedup.....ab061ae922f84305cad17d1e0d173e01