A Data-Analytic Approach Towards Increasing Donor Heart Utilization in the United States

Search for this publication on Google Scholar
Satyanarayana, S. (2018). A Data-Analytic Approach Towards Increasing Donor Heart Utilization in the United States. Unc Charlotte Electronic Theses And Dissertations.
Download PDF

Analytics

115 views ◎
45 downloads ⇓


Abstract

Heart transplantation is the best option available to treat end-stage Heart Failure (HF). There is a shortage of donor hearts in the United States even with the steady increase in the number of donors. One likely reason is the decreasing transplant wait-list mortality resulting from advancements in bridge-to-transplant (BTT) therapies in HF, which causes the candidates to be more selective of donor hearts offered. This study aims to evaluate the changes in the donor characteristics between two decades (1995--2005 and 2005--2015), separated by dramatic increase in BTT.UNOS deceased-donor data was used for the study and divided into two decades with respect to the donor date (1995--2005 and 2005--2015). Two logistic regression models of donor characteristics were derived for the above two decades and used to decide whether an organ is discarded or not. These two models are compared on the actual donor data for 2005--2015. Model 1 (1995--2005) had 5,840 fewer discards than Model 2 (2005--2015). Organs deemed transplantable from two models were simulated using Thoracic Simulated Allocation Model for organ allocation and acceptance.The transplant rate for Model 1 is significantly higher than the Transplant rate for Model 2 at the high-priority status 1A and is not significantly different in lower priorities 1B and 2. However, there was no statistical difference in the mortality rate between the two models in Status 1A.The better performance of Model 1 over Model 2 in both transplant and mortality rates implies that hearts admissible for transplantation are being discarded. The donor-heart quality preferences of transplant candidates for accepting offers are becoming stricter, and is contributing to the donor-heart shortage in the United States.

Details
Author

Satyanarayana, Sagar

Title

A Data-Analytic Approach Towards Increasing Donor Heart Utilization in the United States

Physical Description

1 online resource (52 pages) : PDF

Date

2018

Degree Granting Institution

University of North Carolina at Charlotte

Abstract

Heart transplantation is the best option available to treat end-stage Heart Failure (HF). There is a shortage of donor hearts in the United States even with the steady increase in the number of donors. One likely reason is the decreasing transplant wait-list mortality resulting from advancements in bridge-to-transplant (BTT) therapies in HF, which causes the candidates to be more selective of donor hearts offered. This study aims to evaluate the changes in the donor characteristics between two decades (1995--2005 and 2005--2015), separated by dramatic increase in BTT.UNOS deceased-donor data was used for the study and divided into two decades with respect to the donor date (1995--2005 and 2005--2015). Two logistic regression models of donor characteristics were derived for the above two decades and used to decide whether an organ is discarded or not. These two models are compared on the actual donor data for 2005--2015. Model 1 (1995--2005) had 5,840 fewer discards than Model 2 (2005--2015). Organs deemed transplantable from two models were simulated using Thoracic Simulated Allocation Model for organ allocation and acceptance.The transplant rate for Model 1 is significantly higher than the Transplant rate for Model 2 at the high-priority status 1A and is not significantly different in lower priorities 1B and 2. However, there was no statistical difference in the mortality rate between the two models in Status 1A.The better performance of Model 1 over Model 2 in both transplant and mortality rates implies that hearts admissible for transplantation are being discarded. The donor-heart quality preferences of transplant candidates for accepting offers are becoming stricter, and is contributing to the donor-heart shortage in the United States.

Genre

masters theses

Subjects--Topics

Biometry

Degree

M.S.

Keywords

Heart Utilization
Mechanical Circulatory Support Device
Heart Transplantation

Subject Area

Engineering Management

Advisor(s)

Zenarosa, Gabriel

Committee Members

Lim, Churlzu
Dulin, Michael

Degree Note

Thesis (M.S.)--University of North Carolina at Charlotte, 2018.

Rights Statement

This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). For additional information, see http://rightsstatements.org/page/InC/1.0/.

Rights Holder Information

Copyright is held by the author unless otherwise indicated.

Identifier

Satyanarayana_uncc_0694N_11964

Permalink

http://hdl.handle.net/20.500.13093/etd:235