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The New US Heart Allocation Scheme: Impact on Waitlist and Post-Transplant Survival

  • Thoracic Transplantation (J Patel and AM Holm, Section Editors)
  • Published:
Current Transplantation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

In October 2018, the Organ Procurement and Transplantation Network (OPTN) revised the donor heart allocation system in an attempt to prioritize those patients with highest clinical urgency, reduce waitlist morality, and improve geographic equity in organ allocation. Our goal was to review the changes in the heart allocation policy and its impact on transplant characteristics and outcomes.

Recent Findings

After the new 2018 donor heart allocation system became effective, there has been a trend toward increased use of temporary mechanical circulatory support. Also, initial reports suggested reduced post-transplant survival, although the initial analysis was limited by short follow-up and small sample size. Recent reports however illustrate survival outcomes similar to those of the previous allocation system.

Summary

The new donor heart allocation policy has been associated with a change in management strategies for bridging patients to transplantation, with increased utilization of temporary mechanical circulatory support, with still uncertain effects on post-transplant survival.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA

    Melissa A. Lyle

  2. Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA

    J. David Vega

Authors
  1. Melissa A. Lyle
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  2. J. David Vega
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Correspondence to Melissa A. Lyle.

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Lyle, M.A., Vega, J.D. The New US Heart Allocation Scheme: Impact on Waitlist and Post-Transplant Survival. Curr Transpl Rep 7, 340–345 (2020). https://doi.org/10.1007/s40472-020-00301-2

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  • DOI: https://doi.org/10.1007/s40472-020-00301-2

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