Evolving Trends in Adult Heart Transplant With the 2018 Heart Allocation Policy Change
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Open Access
- 1 February 2021
- journal article
- research article
- Published by American Medical Association (AMA) in JAMA Cardiology
- Vol. 6 (2) , 159-167
Abstract
Heart allocation policy for adult heart transplant in the US was changed by the Organ Procurement and Transplantation Network effective October 18, 2018.1 Namely, the existing 3-tier system was converted to a 6-tier system to provide more granular separation of wait listed patients by clinical condition and urgency of transplant. For example, patients receiving extracorporeal membrane oxygenation (ECMO) were given the highest priority, whereas stable patients with durable left ventricular assist devices (LVADs) were given a lower priority.1 The latter change was implemented because of mounting evidence of improving outcomes of durable LVAD support such that a 2-year survival of 80% could be achieved with contemporary devices.2 The intended impact of changing heart allocation policy in this manner was to reduce wait list mortality and provide broader sharing of donor organs. The aim of this study was to evaluate changes in patient characteristics, wait list outcomes, and posttransplant outcomes in adult heart transplant after the heart allocation policy change.Keywords
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