Heart transplant center practice patterns affect access to donors and survival of patients classified as status 1 by the United Network of Organ Sharing

Objective To determine the effect of adult cardiac transplant center practi ce patterns within a single organ procurement organization on access to don ors and survival for patients listed as United Network of Organ Sharing (UN OS) status 1. Methods A total of 662 patients listed (January 1, 1992, through December 3 1, 1995) as UNOS status 1 for heart transplantation by the 4 adult cardiac transplant centers in an organ procurement organization were analyzed in a retrospective cohort study to determine differences in clinical outcomes. Results The specific center at which an individual was listed as UNOS statu s 1 was a significant independent predictor of receiving a transplant (odds ratios for 3 centers vs center with highest likelihood = 0.73, 0.64, 0.35, respectively; P < .01). Only 1 center had a significantly increased mortal ity rate compared with the other centers (odds ratio 2.03, P < .01). Conclusion Within a single regional organ procurement organization, cardiac transplant centers demonstrate significant variability in the likelihood o f transplantation and survival for patients listed as UNOS status 1.