Variation of heart transplant rates in the United States during holidays.

Background Some cardiac transplant programs may upgrade listed patients to United Network for Organ Sharing (UNOS) 1A-status during the holidays. Whether more transplants actually occur during holidays is unknown. Methods We assessed rates of single-organ heart transplantation from 2001 to 2010 for recipients age 18yr using the UNOS database. Patients were stratified by transplantation during holiday (+/- 3d, n=2375) and non-holiday periods (n=16112). Holidays included Easter/Spring break, Memorial Day, July 4th, Labor Day, Thanksgiving, and Christmas/New Years (winter holidays). Secondary analysis assessing transplant rates across seasons was also completed. Results Donor and recipient characteristics were similar between groups. Compared with non-holidays, July 4th had higher transplant rates (5.69 vs. 5.09transplants/d, p=0.03) while the winter holiday had lower transplant rates (4.50 vs. 5.09transplants/d, p<0.01). There was a trend toward lower transplant rates for all holidays compared with non-holidays (p=0.06). Transplant rates were significantly different across seasons with greater rates in spring and summer (p<0.01). Conclusion Heart transplant rates were higher during the July 4th and lower during the winter holidays. Although there was a higher likelihood of transplantation during the spring and summer seasons, upgrading patients to 1A status during most holidays may not improve their chances for transplantation.