TABLE 1.
US heart transplant candidates by policy period
| December 2016 to February 2018 (pre-policy) n = 4472 |
December 2018 to February 2020 (post-policy) n = 4498 |
Differencea (confidence interval) | |
|---|---|---|---|
| Age at listing (SD) | 53 (13) | 53 (13) | −0.4 (−1 to 0.2) |
| Female (%) | 1156 (26) | 1200 (27) | 0.8 (−1.0% to 2.6%) |
| Race | |||
| White | 2818 (63) | 2723 (61) | −2.5% (−4.5% to −0.5%) |
| Black | 1072 (24) | 1156 (26) | 1.7% (−0.1% to 3.5%) |
| Hispanic | 380 (8) | 430 (10) | 1.1% (−0.1% to 2.3%) |
| Other | 202 (5) | 189 (4) | −0.3% (−1.1% to 0.5%) |
| Smoking history (%) | 1992 (45) | 1870 (42) | −3% (−5.0% to −1.0%) |
| Working for income (%) | 870 (20) | 1039 (24) | 3.6% (1.9% to 5.3%) |
| Education status (%) | |||
| College | 2566 (57) | 2480 (55) | −2.2% (−4.3% to −0.1%) |
| High school | 1642 (37) | 1618 (36) | −0.7% (−2.7% to 1.3%) |
| Less than high school or other | 264 (6) | 400 (9) | 3% (1.9% to 4.1%) |
| BMI (kg/m2) | 27.86 (4.94) | 28.10(5.20) | 0.24 (0.02 to 0.46) |
| Blood type (%) | |||
| A | 1692 (38) | 1676 (37) | −0.6% (−2.6% to 1.4%) |
| AB | 213 (5) | 204 (5) | −0.2% (−1.1% to 0.7%) |
| B | 638 (14) | 656 (15) | 0.3% (−1.2% to 1.8%) |
| O | 1929 (43) | 1962 (44) | 0.5% (−1.6% to 2.6%) |
| Diagnosis (%) | |||
| Dilated cardiomyopathy, non-ischemic | 1947 (44) | 1940 (43) | −0.4% (−2.5% to 1.7%) |
| Ischemic cardiomyopathy | 1354 (30) | 1239 (28) | −2.7% (−4.6% to −0.8%) |
| Restrictive cardiomyopathy | 618 (14) | 700 (16) | 1.7% (0.2% to 3.2%) |
| Other | 553 (12) | 619 (14) | 1.4% (0.0% to 2.8%) |
| Creatinine | 66 (35) | 67 (41) | 0.8 (−0.8 to 2.4) |
| Diabetes | |||
| History of diabetes | 1300 (29) | 1278 (28) | −0.7% (−2.6% to 1.2%) |
| No history of diabetes | 3172 (71) | 3171 (70) | −0.4% (−2.3% to 1.5%) |
| Unknown | 0 (0) | 49 (1) | 1.1% (0.8% to 1.4%) |
| Functional status | |||
| Limited impairment, 70%−100% | 1096 (25) | 975 (22) | −2.8% (−4.5% to −1.1%) |
| Moderate impairment, 50%−60% | 1065 (24) | 923 (21) | −3.3% (−5.0% to −1.6%) |
| Severe impairment, ≤40% | 2212 (49) | 2373 (53) | 3.3% (1.2% to 5.4%) |
| Unknown | 99 (2) | 227 (5) | 2.8% (2.0% to 3.6%) |
| Cardiac index, mL/kg/m2 | 2.18 (1) | 2.15 (1) | −0.03 (−0.05 to −0.01) |
| PCWP, mm Hg | 18 (9) | 18 (9) | −0.2 (−0.6 to 0.2) |
| Payor | |||
| Medicaid | 609 (14) | 615 (14) | 0.1% (−1.3% to 1.5%) |
| Medicare | 1493 (33) | 1364 (30) | −3.1% (−5.0% to −1.2%) |
| Other | 175 (4) | 273 (6) | 2.2% (1.3% to 3.1%) |
| Private | 2195 (49) | 2246 (50) | 0.9% (−1.2% to 3.0%) |
| Pertinent justification at listing | |||
| ECMO | 75 (2) | 112 (2) | 0.8% (0.2% to 1.4%) |
| IABP | 206 (5) | 462 (10) | 5.7% (4.6% to 6.8%) |
| LVAD | 1229 (27) | 1105 (25) | −2.9% (−4.7% to −1.1%) |
| Other MCS | 107 (2) | 139 (3) | 0.7% (0.0% to 1.4%) |
| High-dose inotropes | 445 (10) | 210 (5) | −5.3% (−6.4% to −4.2%) |
| Low-dose inotropes | 1077 (24) | 247 (5) | −18.6% (−20% to −17%) |
| Exception requests | 141 (3) | 852 (19) | 15.8% (14% - 17%) |
| None | 1192 (27) | 1371 (30) | 3.8% (1.9% - 5.7%) |
| 90-day waitlist outcomes | |||
| Mortality | 137 (3) | 68 (2) | −1.6% (−2.2% to −1%) |
| Transplantation | 1539 (34) | 2226 (50) | +15.1% (13% to 17%) |
Note: Values are mean (standard deviation) or n (%). Difference in proportions and associated 95% confidence interval are reported for categorical variables.
Abbreviation: PWCP, pulmonary wedge capillary pressure.
a
Raw mean difference and associated 95% confidence interval are reported for continuous variables.