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Survival while on heart transplantation waiting list varies by sex, UNOS status

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ORLANDO, Fla. — Prospects for survival while on the waiting list for a heart transplant varied by sex depending on listing status, according to a poster presented at the Heart Failure Society of America Scientific Assembly.

Researchers used data from the Scientific Registry of Transplant Recipients database to evaluate 33,069 adult patients with HF (25% women) awaiting orthotopic heart transplantation from 2004 to 2015.

To evaluate sex differences in survival with data stratified by United Network for Organ Sharing (UNOS) status at time of listing, the researchers used Multivariable Cox proportional hazards models.

The primary endpoint was time to all-cause mortality censored at last patient follow-up and time of transplantation.

The cohort consisted of 7,681 patients (26% women) with UNOS Status 1A, 13,027 patients with UNOS Status 1B (25% women) and 12,361 patients (25% women) with UNOS Status 2.

During a median follow-up of 4.3 months, 4,052 men and 1,351 women died, Eileen Hsich, MD, director of the Women’s Heart Failure Clinic and associate medical director for the heart transplant program at Cleveland Clinic, and colleagues reported.

Hsich and colleagues adjusted for more than 20 risk factors to compare risk for death during time on waitlist between men and women.

Compared with men, women had greater risk for death while on the waitlist among patients with UNOS Status 1A (adjusted HR = 1.14; 95% CI 1.01-1.29) and UNOS Status 1B (adjusted HR = 1.17; 95% CI, 1.05-1.3), according to the researchers.

However, they found, among patients with UNOS Status 2, women had less risk for death compared with men (adjusted HR = 0.85; 95% CI, 0.76-0.95).

Rate of transplantation was lower in women than in men among those with UNOS Status 1A, but higher in women than in men among those with UNOS Status 1B or 2, according to the poster.

“The disparity in survival between women and men is concerning given the limited number of donor hearts available every year and the limited research in this field to further evaluate cause,” the researchers wrote. – by Dave Quaile

Reference:

Hsich E, et al. Poster 070. Presented at: Heart Failure Society of America Scientific Assembly; Sept. 17-20, 2016; Orlando, Fla.

Disclosure: Cardiology Today could not obtain relevant financial disclosures.