Heart failure & cardiomyopathiesCohort study
Center and Geographic Variability in Acceptance of the First Donor Heart by Race
- Retrospective analysis of United Network for Organ Sharing data sets
- models with and without listing center effects adjusted for candidate-, donor-, and offer-level variables
Authors' conclusion
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.
Study context
- Population
- Black and White candidates listed for heart transplant in the US (October 18, 2018 to September 30, 2024), first organ offerscandidates (31.6% Black, 68.4% White, 26.5% women)
- Participants
- 20,668 participants
- Exposure
- Black candidates compared with White candidates
Main finding
As reported in the abstract
First offer acceptance
Black candidates vs White candidatesOdds ratio (95% CI)P value
listing center not included in the model; lower for Black candidates
0.84(0.76–0.94)
P = 0.001after adjusting for listing center effects
0.98(0.88–1.10)
P = 0.78Observational data: associations, not effects.
Further findings
Geographic and center patterns of acceptance
- No clear geographic patterns by center
- Centers with lower proportions of Black candidates had higher acceptance rates
Original publication
Center and Geographic Variability in Acceptance of the First Donor Heart by Race. Circ Heart Fail. Published 21 April 2026. doi:10.1161/circheartfailure.125.013986
Summarised from the published abstract; every number is checked against it