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

AbstractPurpose of ReviewIn 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 FindingsAfter 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.SummaryThe 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.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research