Study Population – Center Characteristics
A total of 100 centers performed 17,524 OHTs with a mean age of 53.8 ± 12.3 years, 27% (n=4,587) female and 21.3% (n=3,733) black. The mean Class I and Class II PRA was 7.04±18.4% and 5.01±15.8%, respectively, 78% (n= 13,690) of patients had more than 3 HLA mismatched, 24.2% (n=4,242) gender mismatched and 51.7% (n=9,068) were CMV matched with their donors. Approximately 27.1% (n=4,756) of patients were bridged to OHT with left ventricular assist devices (LVAD) and the basal median estimated rejection risk score was 8 points [IQR 6,9]. The average donor age was 32.1 ± 11.3 years, the mean ischemic time was 3.1 ± 1.0 hours and the median left ventricle ejection fraction was 60% (55, 65) (Supplementary Table 1).
The average rate of induction therapy utilization was 48.6 ± 31.6% (Figure 1), and there were 36, 30 and 34 centers at low (<29%), intermediate (29-66%), and high (>67%) induction utilization rates groups (Table 1). There were no significant differences in age, gender, pre-OHT blood transfusions, calculated PRAs >20% or median pre-OHT rejection risk scores among the groups. Nevertheless, more recipients with elevated creatinine as well as higher rates of HLA and gender mismatch status were in the high tercile. On average, these patients had longer ischemic times and donor-hospital to transplant-center distances. The highest rates of LVAD support were appreciated in the low tercile (30.2% vs 22.4% vs 28.8%, p<0.001).