{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:28:17Z","timestamp":1753878497938,"version":"3.41.2"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The numberof patients awaiting heart transplantation (HTx) substantially exceeds the number of donor hearts transplanted each year, yet nearly 65% of eligible donor hearts are discarded rather than transplanted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Deceased organ donors listed within the UNOS Deceased Donor Database between 2010 and 2020 were reviewed. Those greater than 10 years old and consented for heart donation were included and randomly separated into training (<jats:italic>n<\/jats:italic>\u00a0=\u00a048\u00a0435) and validation (<jats:italic>n<\/jats:italic>\u00a0=\u00a024\u00a0217) cohorts. A discard risk index (DSRI) was created using the results of univariable and multivariable analyses. Discard data were assessed at DSRI value deciles, and stratum\u2010specific likelihood ratio (SSLR) analysis and Kaplan\u2010Meier survival function were used for mortality data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Factors associated with higher DSRI values included donor age\u00a0&gt;\u00a045, LVEF, HBV\u2010core antibodies, hypertension, and diabetes. The DSRI C\u2010statistic was .906 in the training cohort and .904 in the validation cohort. The DSRI did not reliably predict 30\u2010day or 1\u2010year mortality after transplantation (C\u2010statistic .539 and .532, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The factors leading to heart allograft discard are not correlated to the same degree with post\u2010transplant outcomes. This suggests that optimizing utilization of certain allografts with slightly higher risk of discard could increase the heart donor pool with limited impact on posttransplant mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14442","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T14:39:11Z","timestamp":1627483151000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Allograft discard risk index for heart transplantation"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7609-5961","authenticated-orcid":false,"suffix":"Jr.","given":"Ross M.","family":"Reul","sequence":"first","affiliation":[{"name":"Office of Student Affairs Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asad A.","family":"Saleem","sequence":"additional","affiliation":[{"name":"Office of Student Affairs Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian N.","family":"Keller","sequence":"additional","affiliation":[{"name":"Office of Student Affairs Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2795-0527","authenticated-orcid":false,"given":"Tahir H.","family":"Malik","sequence":"additional","affiliation":[{"name":"Office of Student Affairs Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd K.","family":"Rosengart","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Michael E. 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DeBakey Department of Surgery Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12583"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0000000000000393"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.01.022"},{"issue":"13","key":"e_1_2_10_5_1","first-page":"1","article-title":"Donor heart selection: the outcome of \u201cunacceptable\u201d donors","volume":"2","author":"Khasati NH","year":"2007","journal-title":"J Cardiothorac Surg"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000075988"},{"issue":"11","key":"e_1_2_10_7_1","first-page":"S85","article-title":"Post\u2010heart transplant survival is inferior at low\u2010volume centers across all risk strata","volume":"122","author":"Russo MJ","year":"2010","journal-title":"Circulation"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2007.00603.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2019.03.009"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14179"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2018.09.017"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X9301300208"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002151"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2011.11.005"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2011.10.004"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000337"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15201"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.08.004"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2009.08.007"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","unstructured":"ForniA LucianiGB ChiomintoB et al. 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