Maximizing donor allocation: A review of UNOS region 9 donor heart turn-downs

Donna Mancini, Daniel Goldstein, Samantha Taylor, Leway Chen, Alan Gass, Samantha DeLair, Sean Pinney

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


This study was performed to determine if organ selection practices for heart utilization by Region 9 transplant programs were optimal, and to identify opportunities to increase local organ recovery. A retrospective review of de-identified region-wide donor data January 1, 2010 through December 31, 2013 was performed. Over the study period 537 heart donors were identified, of which 321 (60%) were transplanted. Two hundred-sixteen consented hearts were not used; 190 of these were not recovered, and 26 were recovered but not transplanted. Of these, 245/321 (76%) hearts were transplanted at one of 5 regional programs, 15 (5%) were transplanted out of region as primary offers, and 61 (19%) were turned down in region and exported. Of the 61 exported hearts, 43 were turned down in region for donor-related “quality” codes (UNOS 830, 833-837) by at least one program, the remaining 18 hearts were turned down for non-”quality” reasons, primarily histocompatibility and size. Only 5/43 exported were turned down for “quality” reasons by all regional programs offered the organ. A review of consented, not recovered donor offers suggested an additional 28 organs were possibly appropriate for transplant. Our review of regional turn-downs suggests transplant centers could potentially identify additional usable organs without compromising short-term outcomes.

Original languageEnglish (US)
Pages (from-to)3193-3198
Number of pages6
JournalAmerican Journal of Transplantation
Issue number12
StatePublished - Dec 2017


  • clinical research/practice
  • donors and donation
  • heart (allograft) function/dysfunction
  • heart transplantation/cardiology
  • organ procurement and allocation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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