Heart Transplant Centers With and Without Liver Transplant Programs: Analysis of Scientific Registry of Transplant Recipients Metrics

Introduction: We studied the relationship between heart transplant centers with and without liver transplant programs regarding volume, waitlist duration, waitlist survival, and 1-y posttransplant survival.

Methods: Scientific Registry of Transplant Recipients data were acquired in July 2023 and represented transplant centers with adult organ transplant volumes in the United States over the past year. This system involved a five-tier ranking system from one to five, where tier one programs had the lowest rating and tier five programs had the highest rating.

Results: Among heart transplant centers, there were 37 (29.6%) heart-only centers and 88 (70.4%) heart-liver centers. Median heart transplant volume was greater in heart-liver centers (28 [interquartile range: 18-47]) relative to heart-only centers (10 [2-20]; P < 0.001). Median heart waitlist duration rating was higher among heart-liver centers (3 [2-4] versus 2 [2-3]; P = 0.05). A higher waitlist duration rating was associated with greater annual transplant volume (P < 0.001). Waitlist survival rating distributions were similar across heart-only and heart-liver centers (3 [2-4] versus 4 [2-4]; P = 0.33). No significant association was observed between heart transplant volume and waitlist survival rating (P = 0.52). Median posttransplant survival rating between the two transplant center types was also comparable (3 [2-4] versus 3 [2-4]; P = 0.43). A higher posttransplant survival rating was associated with higher transplant volume (P < 0.05).

Conclusions: Heart transplant centers with concomitant liver transplant programs have a superior waitlist duration rating as well as higher overall transplant volumes when compared with heart-only transplant centers.