Center-Level Variations in Maximum Recipient Body Mass Index in Heart Transplantation

This study explored center-level variations in maximum recipient body mass index (BMI) and the associated impact of morbid obesity on outcomes of orthotopic heart transplantation (OHT). Using the United Network for Organ Sharing (UNOS) database, we examined adults (≥18 years) who underwent OHT between 2010 and 2018. Centers performing 40 kg/m2. Kaplan-Meier analysis was utilized to model survival and Cox regression analysis was utilized for adjusted analysis of 1-year mortality. A total of 17,821 candidates underwent OHT with 1,330 having a BMI >35kg/m2. Among 84 centers, a mean of 92.06% of recipients per center had a BMI 40 at each center, respectively. A total of 5, 54, 17, and 8 centers had maximum recipient BMIs of 40 kg/m2, respectively. Centers performing OHT on recipients with higher BMIs displayed higher overall OHT volume (p = 0.002). Rates of post-transplant dialysis (p 40 (HR 2.85, p 38.