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Updated: Jul 9, 2026
A Modified Method for Heterotopic Mouse Heart Transplantion
Published on: June 23, 2014
Clinical course of patients relisted for orthotopic heart transplantation: A national study
David Rekhtman1, Amit Iyengar2, Nikhil Ganjoo1
1Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Insights
Patients relisted for heart transplantation showed similar waitlist outcomes but had worse functional status upon relisting. Relisting often occurred at higher-volume, better-performing centers.
Area of Science:
- Cardiology
- Transplantation Medicine
- Health Services Research
Background:
- Understanding the clinical course of patients relisted for heart transplantation at different centers is limited.
- This study examines baseline characteristics, outcomes, and hospital selection for relisted patients.
Purpose of the Study:
- To compare clinical status and outcomes of heart transplant candidates at initial versus subsequent listing.
- To analyze hospital selection patterns and center performance for relisted patients.
Main Methods:
- Utilized the United Network for Organ Sharing database for adult heart transplant candidates (2018-2023).
- Employed propensity score matching to compare single-listing and relisted patients.
- Assessed waitlist and post-transplant outcomes, functional limitations, listing status, center volume, and center quality.
Main Results:
- No significant differences in waitlist outcomes between single-listing and relisted patients were observed.
- Relisted patients exhibited more severe functional limitations and higher listing status upon subsequent listing.
- Relisted patients were more frequently transferred to higher-volume and better-performing transplant centers.
Conclusions:
- Waitlist outcomes for relisted heart transplant candidates are comparable to single-listed patients.
- Patients relisted for heart transplantation present with increased functional limitations and higher acuity.
- Further research is necessary to identify the drivers behind patient relisting decisions.
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.
