Table 2. Comparison of Recipient, Donor, and Transplant-Related Characteristics at the Time of Transplant Before and After the Change in Heart Allocation Policya.
| Characteristic | Before change (n = 6078) | After change (n = 2801) | P value |
|---|---|---|---|
| Recipients | |||
| Age, mean (SD), y | 53.9 (12.7) | 52.8 (13.1) | <.001 |
| Male sex | 4347 (71.5) | 1981 (70.7) | .44 |
| Race/ethnicity | |||
| White | 3910 (64.7) | 1754 (62.9) | .09 |
| Black | 1313 (21.7) | 629 (22.5) | |
| Hispanic | 555 (9.2) | 285 (10.2) | |
| Asian | 227 (3.8) | 113 (4.1) | |
| Other | 40 (0.7) | 9 (0.3) | |
| BMI, mean (SD) | 27.4 (4.8) | 27.3 (5.0) | .53 |
| Blood type | |||
| A | 2549 (41.9) | 1153 (41.2) | .54 |
| AB | 389 (6.4) | 173 (6.2) | |
| B | 960 (15.8) | 476 (17.0) | |
| O | 2180 (35.9) | 999 (35.7) | |
| Cause of heart failure | |||
| Nonischemic dilated cardiomyopathy | 3303 (55.8) | 1491 (56.2) | .002 |
| Ischemic cardiomyopathy | 1841 (31.1) | 743 (28.0) | |
| Congenital heart disease | 159 (2.7) | 98 (3.7) | |
| Restrictive cardiomyopathy | 241 (4.1) | 153 (5.4) | |
| Valvular heart disease | 69 (1.2) | 28 (1.1) | |
| Failed primary heart transplant | 121 (2.0) | 64 (2.4) | |
| Hypertrophic cardiomyopathy | 183 (3.1) | 85 (3.2) | |
| Diabetes | 1716 (28.2) | 727 (26.5) | .09 |
| Serum bilirubin, mean (SD), mg/dL | 0.92 (1.54) | 1.14 (2.87) | <.001 |
| Serum creatinine, mean (SD), mg/dL | 1.24 (0.76) | 1.19 (0.48) | <.001 |
| Cytomegalovirus positive | 3358 (55.3) | 1403 (50.1) | <.001 |
| Pretransplant mechanical ventilatory support | 63 (1.0) | 80 (2.9) | <.001 |
| Pretransplant intensive care unit | 1907 (31.4) | 1543 (55.1) | <.001 |
| Intra-aortic balloon pump | 534 (8.8) | 887 (31.7) | <.001 |
| Extracorporeal membrane oxygenation | 71 (1.2) | 172 (6.1) | <.001 |
| Bridge with ventricular assist device | |||
| None | 3381 (55.6) | 1823 (71.5) | <.001 |
| Left ventricular assist device | 2549 (41.9) | 651 (25.5) | |
| Right ventricular assist device | 9 (0.2) | 10 (0.4) | |
| Total artificial heart | 50 (0.8) | 14 (0.6) | |
| Biventricular assist device | 89 (1.5) | 51 (2.0) | |
| Type of left ventricular assist device | |||
| HeartMate 2 | 1168 (19.2) | 107 (3.8) | <.001 |
| HeartWare | 966 (15.9) | 203 (7.3) | <.001 |
| HeartMate 3 | 68 (1.1) | 239 (8.5) | <.001 |
| Other durable device | 399 (6.6) | 124 (4.4) | <.001 |
| Temporary device | 62 (1.0) | 105 (4.2) | <.001 |
| Donors | |||
| Age, mean (SD), y | 32.1 (10.9) | 32.4 (10.8) | .08 |
| Male sex | 4103 (67.5) | 1999 (71.4) | <.001 |
| Race/ethnicity | |||
| White | 3906 (64.3) | 1806 (64.5) | .56 |
| Black | 992 (16.3) | 430 (15.4) | |
| Hispanic | 973 (16.0) | 478 (17.1) | |
| Asian | 100 (1.7) | 42 (1.5) | |
| Other | 107 (1.8) | 45 (1.6) | |
| BMI, mean (SD) | 27.5 (6.2) | 27.7 (6.1) | .06 |
| Blood type | |||
| A | 2395 (39.4) | 1046 (37.3) | .33 |
| AB | 92 (1.5) | 43 (1.5) | |
| B | 697 (11.5) | 333 (11.9) | |
| O | 2894 (47.6) | 1379 (49.2) | |
| Mechanism of donor death | |||
| Trauma | 2684 (44.2) | 1149 (41.0) | <.001 |
| Cerebrovascular | 1023 (16.8) | 416 (14.9) | |
| Drug overdose | 1116 (18.4) | 608 (21.7) | |
| Other | 1252 (20.6) | 628 (22.4) | |
| Diabetes | 227 (3.8) | 86 (3.1) | .12 |
| Hypertension | 2047 (33.8) | 941 (35.5) | .11 |
| Hepatitis C positive | 259 (4.3) | 321 (11.5) | <.001 |
| Cytomegalovirus positive | 3696 (61.2) | 1747 (62.8) | .16 |
| Terminal serum creatinine, mean (SD), mg/dL | 1.53 (1.58) | 1.69 (1.81) | <.001 |
| Left ventricular ejection fraction <50% | 83 (1.4) | 36 (1.3) | .76 |
| Recipient-donor matching | |||
| Sex matched | 4618 (76.0) | 2175 (77.7) | .08 |
| Race/ethnicity matched | 3131 (51.5) | 1378 (49.2) | .04 |
| HLA matched (≥3 antigens) | 778 (12.8) | 354 (12.6) | .83 |
| Blood type matched | 5089 (83.7) | 2309 (82.4) | .13 |
| Cytomegalovirus status matched | 3230 (53.5) | 1441 (51.8) | .14 |
| Transplant Related | |||
| Time on wait list, mean (SD), d | 134.5 (162.6) | 55.4 (83.0) | <.001 |
| Donor hospital to transplant center distance, mean (SD), miles | 157.3 (196.8) | 279 (238.1) | <.001 |
| Cold ischemic time, mean (SD), h | 3.04 (1.05) | 3.41 (1.00) | <.001 |
| Status at transplant | |||
| Old status | NA | ||
| 1A | 4159 (68.4) | NA | |
| 1B | 1746 (28.7) | NA | |
| 2 | 173 (2.9) | NA | |
| New status | |||
| 1 | NA | 272 (9.7) | |
| 2 | NA | 1446 (51.6) | |
| 3 | NA | 544 (19.4) | |
| 4 | NA | 430 (15.4) | |
| 5 | NA | 0 | |
| 6 | NA | 108 (3.9) | |
Abbreviations: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); NA, not applicable.
SI conversion factors: To convert bilirubin to micromoles per liter, multiply by 17.104; to convert creatinine to micromoles per liter, multiply by 88.4.
a
Data are presented as number (percentage) of patients unless otherwise indicated.