Impact of institutional variables on centre performance in long-term survival after heart transplant

• DOI: 10.1093/icvts/ivae111
• Publication Date: 2024-06-14T11:52:37Z
• Authors: Weston E McDonald; Khaled Shorbaji; Maxwell Kilcoyne; William Few; Brett Welch; Zubair Hashmi; Arman Kilic
• Keywords: Single Center; Log-rank test

Abstract OBJECTIVES The gold standard metric for centre-level performance in orthotopic heart transplantation (OHT) is 1-year post-OHT survival. However, it unclear whether centre at 1 year predictive of longer-term outcomes. This study evaluated factors impacting OHT. METHODS Patients who underwent OHT the USA between 2010 and 2021 were identified using United Network Organ Sharing data registry. primary outcome was 5-year survival conditional on following Multivariable Cox proportional hazard models assessed impact rates rates. Mixed-effect used to evaluate between-centre variability RESULTS Centre-level risk-adjusted mortality not associated with [hazard ratio: 0.99 (0.97–1.01, P = 0.198)]. Predictors included black recipient race, pre-OHT serum creatinine, diabetes donor age. In mixed-effect modelling, there substantial centres survival, a finding that persisted after controlling recipient, institutional (P < 0.001). crude analysis Kaplan–Meier, was: low volume: 86.5%, intermediate 87.5%, high 86.7% (log-rank 0.52). These measured variables only accounted 21.4% CONCLUSIONS outcomes do correlate 1- period Further research needed determine what unmeasured contribute