Background
The existence of a “weekend effect” in heart transplantation (HTx) is understudied.
The present study sought to determine whether the odds of (HTx) offer acceptance differed
for adult and pediatric candidates depending upon the day on which the offer occurred.
Methods
United Network for Organ Sharing data were used to identify all HTx offers to adult
(listing age ≥18) and pediatric candidates from 2000-2019. Odds of offer acceptance
were studied, comparing weekends, holidays, and conferences (Society of Thoracic Surgeons
[STS], American Association for Thoracic Surgery [AATS], International Society for
Heart and Lung Transplantation [ISHLT]) to “baseline” (all other days). Multivariable
binary logistic regression analyses were performed to determine independent predictors
of offer nonacceptance, controlling for the impacts of program transplant volume,
region, and candidate characteristics.
Results
A total of 323,953 offers occurred – 298,405 to adults and 25,548 to pediatric candidates.
Clinically significant differences did not exist in donor or candidate characteristics
between baseline or other events. The number of offers per day was stable throughout
the year for both adults (p = 0.191) and pediatrics (p = 0.976). In adults, independently lower odds of acceptance existed on weekends (OR
0.88 [95% CI 0.84-0.92]), conferences in aggregate (0.86 [0.77-0.95]), and holidays
in aggregate (0.81 [0.72-0.91]). In children, independently lower odds of acceptance
were seen on weekends (0.88 [0.79-0.98]), during STS (0.46 [0.25-0.83], and during
Christmas (0.32 [0.14-0.76]).
Conclusions
The day on which a HTx offer occurs significantly impacts its likelihood of acceptance.
Further work can determine the impacts of human behavior or resource distribution,
but knowledge of this phenomenon can inform efforts to ensure ideal organ allocation
throughout the year.
KEYWORDS
Abbreviations:
AATS (American Association for Thoracic Surgery), CI (confidence interval), ISHLT (International Society for Heart and Lung Transplantation), PTR (Potential Transplant Recipient), UNOS (United Network for Organ Sharing), STS (Society of Thoracic Surgeons.)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 02, 2022
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© 2022 International Society for Heart and Lung Transplantation. All rights reserved.
