Abstract
<h3>Purpose</h3> Late stage dilated cardiomyopathy is one of the primary indications for heart transplant. We sought to see what baseline characteristics changed and if survival differed in dilated cardiomyopathy patients who underwent heart transplant in the one-year before and after the UNOS status change. <h3>Methods</h3> In the UNOS database, 2961 dilated cardiomyopathy patients underwent heart transplant (Exclusions: age<18, re-HT & lost to followup) within 1-year pre and post UNOS policy change (10/18/2018). Pre-policy era (n=1582) and post-policy era (n=1379) baseline characteristics were compared via standard statistical analysis, reported in median and IQR. Kaplan Meier survival analysis (censored at 6 months) and univariate cox regression were performed. Multivariate cox proportional hazard regression analysis was adjusted for age, donor age, creatinine, bilirubin, dialysis, and ischemic time. <h3>Results</h3> The post group was younger (56 yo [47.0-63.0] vs 58 yo [49.0-64.0], p=0.002) and had lower creatinine levels (1.1 mg/dL [0.9-1.4] vs 1.2 [1.0-1.5], p<0.001). BMI, DM status, dialysis status, ethnicity and donor age did not differ between groups. Distance from donor hospital to transplant (86.0 mi [13.0-260.0 mi] vs 230.0 mi [81.0-411.0 mi], p<0.001) and ischemic time (3.0 hr [2.2-3.6 hr] vs 3.4 hr [2.8-4.0 hr], p<0.001) were increased in the post group compared to the pre group. Patients in the post era had similar survival compared to pre (93% vs 94%, log-rank p=0.15) at 6 months. Unadjusted HR for all-cause mortality was nonsignificant for post compared to pre. Multivariate analysis was nonsignificant for the post era compared to pre after adjusting for age, donor age, creatinine, dialysis status, and ischemic time. <h3>Conclusion</h3> The distance of donor hospital to transplant center were farther and ischemic time were longer in the post-era policy change but the survival outcomes did not differ for dilated cardiomyopathy patients undergoing heart transplantation.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
