Choi AY, Mulvihill MS, Lee HJ, et al. - Researchers examined if transplant center variability in offer acceptance is linked with mortality among patients on the heart transplant waitlist. Using the US National Transplant Registry, researchers conducted a cohort study of 9,628 candidates for heart transplant over 10 years. A 27% reduction in the rate of mortality was observed among patients on the waitlist in correlation with every 10% increase in adjusted center acceptance rate of offers made to the highest-priority candidates; this was observed with no detriment in 5-year adjusted posttransplant patient survival or graft failure. Observations thereby suggest that center-level decision to accept or decline an allograft is possibly a modifiable behavior that is linked with mortality among patients on the heart transplant waitlist.