Transplant Outcomes of Adult Donor Hearts with Prior Quality-based Offer Refusals

Heart transplantation is the definitive therapy for the end-stage heart failure patients with a 5-year post-transplant survival rate of over 70%. However, the therapy is not available to many due to the severe shortage of donor hearts. Furthermore, many donor heart are not utilized which compounds the shortage problem. This paper investigates whether donor hearts declined by transplant centers and subsequently transplanted had worse outcomes compared to donor hearts immediately accepted and transplanted.