Practice Changes at U.S. Transplant Centers After the New Adult Heart Allocation Policy.

Journal of the American College of Cardiology
William F ParkerMatthew M Churpek

Abstract

In October 2018, the U.S. heart allocation system expanded the number of priority "status" tiers from 3 to 6 and added cardiogenic shock requirements for some heart transplant candidates listed with specific types of treatments. This study sought to determine the impact of the new policy on the treatment practices of transplant centers. Initial listing data on all adult heart candidates listed from December 1, 2017 to April 30, 2019 were collected from the Scientific Registry of Transplant Recipients. The status-qualifying treatments (or exception requests) and hemodynamic values at listing of a post-policy cohort (December 2018 to April 2019) were compared with a seasonally matched pre-policy cohort (December 2017 to April 2018). Candidates in the pre-policy cohort were reclassified into the new priority system statuses by using treatment, diagnosis, and hemodynamics. Comparing the post-policy cohort (N = 1,567) with the pre-policy cohort (N = 1,606), there were significant increases in listings with extracorporeal membrane oxygenation (+1.2%), intra-aortic balloon pumps (+ 4 %), and exceptions (+ 12%). Listings with low-dose inotropes (-18%) and high-dose inotropes (-3%) significantly decreased. The new priority status distri...Continue Reading

References

Sep 29, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Jose N NativiJosef Stehlik
Jan 27, 2017·Circulation·Emelia J BenjaminUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Jun 6, 2017·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·William F ParkerMatthew M Churpek
Dec 17, 2017·Circulation. Heart Failure·William F ParkerMatthew M Churpek
Jan 3, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M ColvinB L Kasiske
Apr 19, 2018·Journal of the American College of Cardiology·William F ParkerMatthew M Churpek
Feb 28, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M ColvinB L Kasiske
Nov 13, 2019·JAMA : the Journal of the American Medical Association·William F ParkerMatthew M Churpek

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Citations

Dec 6, 2020·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Matthew H GonzalezRenzo Y Loyaga-Rendon
Jan 27, 2021·European Journal of Internal Medicine·Emmanuel AkintoyeAlexandros Briasoulis
Dec 19, 2020·Transplantation Direct·David A Baran
Apr 18, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Gege RanWilliam F Parker
May 4, 2021·Current Opinion in Organ Transplantation·Peter J AltshulerPavan Atluri
Jun 9, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·John J SquiersShelley A Hall
May 20, 2021·Current Opinion in Organ Transplantation·Peter J AltshulerPavan Atluri
Jun 13, 2020·Journal of the American College of Cardiology·Ashish S Shah, Lynne Warner Stevenson
Aug 23, 2021·The Annals of Thoracic Surgery·Taylor NordanMasashi Kawabori
Dec 25, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Kevin A LazenbyWilliam F Parker

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