ArticleJACC. Heart failure2020
Reassessing Recipient Mortality Under the New Heart Allocation System: An Updated UNOS Registry Analysis.
Article in JACC. Heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
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Who cites it
38 citing papers in PubMed, 109 citations in OpenAlex.
- Risk Analysis of Waiting-List Mortality in Heart Transplantation: A Multicenter Study in Korea.Yonsei medical journal · 2026Article
- Potential Impact of the OPTN Status Escalation Policy for Adult Heart Transplant Candidates With Durable LVADs.Circulation. Heart failure · 2026Article
- Rethinking Readmissions in Advanced Heart Failure: Insights From Left Ventricular Assist Device and Heart Transplant Care.Journal of the American Heart Association · 2026Article
- Use of intraoperative right ventricular strain as a predictor of outcomes in adult heart transplant patients.Frontiers in cardiovascular medicine · 2026Article
- Impact of 2018 allocation system change on heart transplantation outcomes in china: a retrospective analysis.European journal of medical research · 2025Article
- Prolonged Impella 5.5 Support in Patients with Cardiogenic Shock: A Single-Center Retrospective Analysis.Journal of clinical medicine · 2025Article
- Differences in wait-list mortality: Temporary vs durable circulatory support devices.JHLT open · 2025Article
- Insights into the history and tendency of cardiac transplantation for heart failure: A bibliometric-based visual analysis.International journal of cardiology. Heart & vasculature · 2025Article
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- Improving the Prioritization of Heart Transplantation Candidates for Optimal Clinical Outcomes: A Narrative Review.Current cardiology reports · 2025Review
- Mechanical circulatory support as a cornerstone in advanced heart failure and transplantation.Frontiers in cardiovascular medicine · 2025Review
- Survival trends in heart transplant patients supported on ECMO and IABP: A 10-year UNOS database analysis.International journal of cardiology. Heart & vasculature · 2024Article
- Impact of Left Ventricular Unloading on Outcome of Heart Transplant Bridging With Extracorporeal Membrane Oxygenation Support in New Allocation Policy.Journal of the American Heart Association · 2024Article
- Use of mechanical circulatory support and survival for heart and heart-kidney transplant recipients in the new allocation system.JHLT open · 2024Article
- Bridging Over Troubled Waters-How the United States 2018 Heart Allocation System Altered Transplant Bridging Strategies.Reviews in cardiovascular medicine · 2024Review
- The impact of obesity and LVAD-bridging on heart transplant candidate outcomes: a linked STS INTERMACS - OPTN/UNOS data analysis.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2023Article
- Impact of the 2018 UNOS Heart Transplant Policy Changes on Patient Outcomes.JACC. Heart failure · 2023Review
- Temporary Mechanical Circulatory Support in Patients with Cardiogenic Shock: Clinical Characteristics and Outcomes.Journal of clinical medicine · 2023Article
- Outcomes after heart transplantation in patients who have undergone a bridge-to-bridge strategy.JTCVS open · 2022Article
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAn early report of recipient heart transplantation outcomes under the new U.S. heart allocation system introduced in late 2018 found a lower post-transplant survival rate compared with that of the prior system.
objectivesThe aim of this study was to examine recipient survival under the new system by using an updated dataset.
methodsThe 2015 to 2019 United Network for Organ Sharing registry was queried for adult heart transplant recipients, stratified according to whether the subjects were listed and underwent transplant before or after October 18, 2018, when the new allocation system was implemented. The association between allocation system and recipient mortality was analyzed by using the Kaplan-Meier method and multivariable Cox proportional hazards regression.
resultsA total of 7,119 recipients met inclusion criteria: 6,004 (84%) and 1,115 (16%) listed and undergoing transplant in the old and new allocation systems, respectively. This registry update included 576 new-system recipients, more than double the amount previously analyzed. Recipients from the new system were more likely to be bridged to transplant with temporary mechanical circulatory support devices instead of durable left ventricular assist devices and had longer graft ischemic times. After adjustment, the new system was not associated with poorer survival on Kaplan-Meier survival analysis (log-rank test; p = 0.075) or multivariable Cox proportional hazards modeling (adjusted hazard ratio: 1.18; 95% confidence interval: 0.90 to 1.55).
conclusionsThe short-term survival of recipients listed and receiving a transplant under the old and new allocation systems seems to be comparable. The modification to the allocation system has resulted in several changes to the clinical profiles of patients undergoing transplants that must be closely monitored in the coming years.
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