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Supplementary Material
Figure S1
Figure S2
Figure S3
Figure S4
Table S1
Table S2
Figure S1
Figure S1: Total active waiting time spent at each priority status by the priority status at initial
listing for heart transplant. The percentage of the total active waiting time was computed for
each active status (1A, 1B and 2) for the study cohort, as divided by the priority status at initial
waiting list addition. For candidates initially listed at priority status 1A, 1B and 2, the majority of
active time was spent at that status (65.0%, 77.2% and 61.7%, respectively). For candidates
initially listed at priority status 7, the majority of time was spent at status 1B (61.3%).
Figure S2
Figure S2: Plot of the percentage of total heart transplant candidates added to the waiting list
with unacceptable HLA antigens (UA-HLA) entered from 1997 to 2013. The percentage of
candidates with UA-HLA was over 1% between years 2006 and 2013. The peak year was 2010
with 24.9% of heart transplant candidates listed with UA-HLA.
Figure S3
Figure S3: Change in calculated panel reactive antibody (CPRA) values in the study cohort
while on the waiting list. A: CPRA values were static (no change) in 2,447 (63.5%) candidates
and were dynamic (changed) in 1,408 candidates (36.5%). B: In candidates with dynamic
CPRA, 802 (57.0%) candidates displayed an increase in CPRA (positive change) from the first
to last CPRA value, and 606 (43.0%) candidates displayed a decrease in CPRA (negative
change) from the first to last CPRA value. Each vertical column represents an interval of 5%
CPRA.
Figure S4
Figure S4: Distribution of CPRA values for heart transplant candidates who did not receive a
transplant as compared to those that did receive a transplant. CPRA values in candidates that
did not receive a transplant (and either were still waiting, were removed or died on the waiting
list) were higher than in candidates that did receive a transplant (median CPRA 46% vs 26%, p
< 0.001).
Table S1: Characteristics of Patients Listed With and Without Unacceptable Antigens in
the UNOS Database
With UA
(n=3,978)
Without UA
(n=19,311)
Total
(n=23,389)
P value
Age (years) 52.0 52.7 52.6 0.007
Creatinine (mg/dL) 1.37 1.35 1.36 0.517
Female sex 1,486 (37.4%) 4,451 (22.9%) 5,937 (25.4%) <0.001
Previous HT 134 (3.4%) 407 (2.1%) 541 (2.3%) <0.001
Previous cardiac surgery <0.001
No 2,229 (56.0%) 1,188 (61.2%) 14,109 (60.3%)
Yes 1,732 (43.5%) 7,427 (38.3%) 9.159 (39.2%)
Unknown 17 (0.4%) 104 (0.5%) 121 (0.5%)
Ethnicity <0.001
Caucasian 2,556 (64.3%) 13,346 (68.8%) 15,902 (68.0%)
African American 1,092 (27.5%) 3,766 (19.4%) 4,858 (20.8%)
Latino 206 (5.2%) 1,532 (7.9%) 1,738 (7.4%)
Asian and Other 124 (3.1%) 767 (4.0%) 891 (3.8%)
UNOS region <0.001
Region 1 51 (1.3%) 1,029 (5.3%) 1,080 (4.6%)
Region 2 463 (11.6%) 2,627 (13.5%) 3,090 (13.2%)
Region 3 479 (12.0%) 2,309 (11.9%) 2,788 (11.9%)
Region 4 557 (14.0%) 1,998 (10.3%) 2,555 (10.9%)
Region 5 553 (13.9%) 2,705 (13.9%) 3,258 (13.9%)
Region 6 96 (2.4%) 500 (2.6%) 596 (2.6%)
Region 7 515 (13.0%) 1,839 (9.5%) 2,354 (10.1%)
Region 8 254 (6.4%) 1,107 (5.7%) 1,361 (5.8%)
Region 9 25 (0.6%) 1,616 (8.3%) 1,641 (7.0%)
Region 10 429 (10.8%) 1,530 (7.9%) 1,959 (8.4%)
Region 11 556 (14.0%) 2,151 (11.1%) 2,707 (11.6%)
MCS at transplant <0.001
None 2,852 (71.7%) 15,665 (80.7%) 18,517 (79.2%)
Left or right VAD 1,011 (25.4%) 3,181 (16.4%) 4,192 (17.9%)
BiVAD or TAH 115 (2.9%) 560 (2.9%) 675 (2.9%)
Initial priority status <0.001
1A 725 (18.2%) 4,170
(21.5%)
4,895 (20.9%)
1B 1,690 (42.5%) 7,403 (38.1%) 9,093 (38.9%)
2 1,462 (36.8%) 7,212 (37.2%) 8,674 (37.1%)
7 101 (2.5%) 626 (3.2%) 727 (3.1%)
UNOS = United Network for Organ Sharing; UA = unacceptable antigens; HT = heart transplant;
MCS = mechanical circulatory support; VAD = ventricular assist device; BiVAD = biventricular
assist device; TAH = total artificial heart.
Table S2: Post-Transplant Survival By CPRA Group
Group Hazard Ratio 95% Confidence
Interval
P value
Control (PRA 0%) reference reference reference
Group 1 (CPRA 0% to 20%) 1.00 0.83 - 1.20 0.997
Group 2 (CPRA 20.1% to 40%) 1.24 1.00 - 1.54 0.046
Group 3 (CPRA 40.1% to 60%) 1.39 1.09 - 1.77 0.008
Group 4 (CPRA 60.1% to 80%) 1.33 0.99 - 1.78 0.055
Group 5 (CPRA 80.1% to 100%) 1.32 0.96 - 1.81 0.092