Evidence map›Paper›PMID 40310329›Full record

ArticleJACC. Advances2025

Moving Beyond the Perfect Donor: An Interdisciplinary Approach to Optimizing Donor Utilization.

Aditi Venkatraman, Lebei Pi, David Belzile, Marisa Signorile, Chun-Po S Fan, Nitish Dhingra, Natasha Aleksova, Adriana C Luk, Bryce Alexander, Filio Billia and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Aditi VenkatramanTemerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Lebei PiAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
David BelzileIUCPQ, Quebec City, Quebec, Canada.
Marisa SignorileTed Rogers Computational Program, University Health Network, Toronto, Ontario, Canada.
Chun-Po S FanTed Rogers Computational Program, University Health Network, Toronto, Ontario, Canada.
Nitish DhingraAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Natasha AleksovaAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada.
Adriana C LukAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Bryce AlexanderAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Filio BilliaAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Ana C AlbaAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Juglans AlvarezAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Juan G Duero PosadaAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Jeremy KobulnikAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Deepali KumarAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Heather J RossAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Vivek RaoAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Michael A McDonaldAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.
Yasbanoo MoayediAjmera Transplant Centre, University Health Network, Toronto, Ontario, Canada. Electronic address: yas.moayedi@uhn.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite a growing demand for donor hearts, more than two-thirds of viable hearts are discarded in North America. Our initiative sought to improve donor heart utilization by reviewing institutional donor acceptance practices and implementing targeted interventions.

objectivesOur aim was to increase donor heart utilization rate to 20% and reduce the rate of missed viable opportunities to ≤10% within a 12-month period, and assess the incidence of primary graft dysfunction preintervention and postintervention.

methodsThis prospective single-center study included all donor heart offers from January 1, 2021, to December 31, 2023. Donor demographics, clinical data, and utilization outcomes were collected. Missed viable opportunities were defined by criteria including left ventricular ejection fraction >50%, age <45 years, ischemic time <4 hours, and ≤20% undersizing by predicted heart mass. In January 2023, we launched a dashboard to track and display real-time utilization rates, held a Vanguard international speaker series, and introduced cardiologist/surgeon donor report cards.

resultsBefore the interventions (January 2021-December 2022), 54 of 436 (12.4%) donor offers were utilized; postintervention (January 2023-December 2023), 43 out of 233 offers (18.5%) were utilized (P = 0.038). Missed viable opportunities decreased from 19.3% (2021-2022) to 8.6% (2023) (P < 0.001). Additionally, there was a trend toward reduction in severe primary graft dysfunction (26% vs 12%, P = 0.121) postintervention.

conclusionsOur interdisciplinary, multipronged interventions doubled our donor heart utilization rate and significantly reduced missed viable opportunities without compromising short-term heart transplant recipient outcomes.

Indexed as

donor managementdonor utilizationheart transplantation

Identifiers

PMID40310329
PMCPMC12717586

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.