Impact of the new heart allocation policy on patients with restrictive, hypertrophic, or congenital cardiomyopathies

Fouad Chouairi, Clancy W Mullan, Sounok Sen, Makoto Mori, Michael Fuery, Robert W Elder, Joshua Lesse, Kelsey Norton, Katherine A Clark, P Elliott Miller, David Mulligan, Richard Formica, Joseph G Rogers, Daniel Jacoby, Christopher Maulion, Muhammad Anwer, Arnar Geirsson, Nihar R Desai and Tariq Ahmad

PLOS ONE, 2021, vol. 16, issue 3, 1-10

Abstract: Background: Patients with restrictive or hypertrophic cardiomyopathy (RCM/HCM) and congenital heart disease (CHD) do not derive clinical benefit from inotropes and mechanical circulatory support. Concerns were expressed that the new heart allocation system implemented in October 2018 would disadvantage these patients. This paper aimed to examine the impact of the new adult heart allocation system on transplantation and outcomes among patients with RCM/HCM/CHD. Methods: We identified adult patients with RCM/HCM/CHD in the United Network for Organ Sharing (UNOS) database who were listed for or received a cardiac transplant from April 2017-June 2020. The cohort was separated into those listed before and after allocation system changes. Demographics and recipient characteristics, donor characteristics, waitlist survival, and post-transplantation outcomes were analyzed. Results: The number of patients listed for RCM/HCM/CHD increased after the allocation system change from 429 to 517. Prior to the change, the majority RCM/HCM/CHD patients were Status 1A at time of transplantation; afterwards, most were Status 2. Wait times decreased significantly for all: RCM (41 days vs 27 days; P

Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0247789

DOI: 10.1371/journal.pone.0247789

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