{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:46:03Z","timestamp":1791906363604,"version":"4.3.4"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Among accepted US heart organs, listing centers accept organ offers earliest for White women, followed by Black women, White men, and Black men. Understanding the relationships of center- and geographic-level decisions is necessary to understand waitlist disparities. We sought to determine whether listing center and geography are associated with the first heart organ acceptance by candidate race, since race demographics vary regionally across the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Using the United Network for Organ Sharing data sets, we identified first organ offers for Black and White candidates listed for heart transplant (October 18, 2018 to September 30, 2024) and compared models with and without listing center effects adjusted for candidate-, donor-, and offer-level variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 20\u2009668 candidates (31.6% Black, 68.4% White, 26.5% women), the adjusted odds of first offer acceptance were lower for Black candidates compared with White candidates (odds ratio, 0.84 [95% CI, 0.76\u20130.94];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.001) when listing center was not included in the model; but after adjusting for listing center effects, odds were similar by race (odds ratio, 0.98 [95% CI, 0.88\u20131.10];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.78). There were no clear geographic patterns by center, but centers with lower proportions of Black candidates had higher acceptance rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Variability in overall acceptance rate among listing centers explains the lower first offer acceptance for Black compared with White heart candidates. Baseline acceptance rates were linked to the center-level proportion of Black candidates but not geography. Investigation of strategies to systemically improve early acceptance of good heart organs may reduce Black and White disparities in wait time duration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.125.013986","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T18:00:22Z","timestamp":1776794422000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Center and Geographic Variability in Acceptance of the First Donor Heart by Race"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5397-6419","authenticated-orcid":true,"given":"Khadijah","family":"Breathett","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Krannert Cardiovascular Research Center, Indiana University, Indianapolis (K.B., S.M.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9017-7007","authenticated-orcid":true,"given":"Shannon M.","family":"Knapp","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Krannert Cardiovascular Research Center, Indiana University, Indianapolis (K.B., S.M.K.)."},{"name":"Department of Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health, Indianapolis, IN (S.M.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4215-795X","authenticated-orcid":true,"given":"Edward J.","family":"Bedrick","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of Arizona, Tucson (E.J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9045-7722","authenticated-orcid":true,"given":"Ryan J.","family":"Tedford","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Medical University of South Carolina, Charleston (R.J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5145-7420","authenticated-orcid":true,"given":"Shannon M.","family":"Dunlay","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (S.M.D.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3553-2720","authenticated-orcid":true,"given":"Selma F.","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Public Health Division of Cardiovascular Medicine, Creighton University, Omaha, NE (S.F.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9294-4612","authenticated-orcid":true,"given":"Monica M.","family":"Colvin","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Michigan, Ann Arbor (M.C.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4266-0722","authenticated-orcid":true,"given":"Richard","family":"Daly","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery (R.D.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.052254"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.020146"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.013592"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.11044"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001016"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.122.009745"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2025.01.024"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.0065"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.13723"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/00031305.1982.10482778"},{"key":"e_1_3_3_12_2","unstructured":"jnewman. 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