National decline in donor heart utilization with regional variability: 1995-2010.

Area of Science:

• Transplantation Medicine
• Cardiology
• Public Health

Background:

• End-stage heart disease presents a growing challenge due to a severe shortage of donor hearts.
• Limited donor heart availability restricts transplantation options for eligible patients.
• Understanding donor heart acceptance trends is crucial for optimizing organ utilization.

Purpose of the Study:

• To analyze national trends in donor heart acceptance for transplantation.
• To identify demographic and clinical factors influencing donor heart acceptance.
• To examine regional variations in donor heart utilization.

Main Methods:

• Analysis of data from the Organ Procurement and Transplantation Network (OPTN) for adult cardiac donors (1995-2010).
• Categorization of donor heart disposition: transplanted, declined, or other uses.
• Statistical examination of changes in acceptance probability based on donor characteristics and UNOS region.

Main Results:

• Out of 82,053 potential donor hearts, 34% were accepted, 48% declined, and 18% used otherwise.
• Donor heart acceptance declined from 44% in 1995 to 29% in 2006, then rose to 32% in 2010.
• Older donor age, female sex, and medical comorbidities were associated with non-acceptance, with increasing prevalence of these factors over time.

Conclusions:

• Donor heart acceptance rates have fluctuated, impacted by donor demographics and health status.
• While predictors of non-acceptance are consistent across regions, utilization rates vary, suggesting room for improvement.
• Evidence-based criteria and targeted regional strategies are needed to enhance donor heart acceptance and transplantation rates.