ArticleJournal of cardiac failure2026
Out-of-Sequence Donor Heart Allocation: A United Network for Organ Sharing Registry Analysis.
Article in Journal of cardiac failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Evolution of out-of-sequence liver allocation, 2019-2024.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- The impact of simultaneous batch turn downs and targeted kidney utilization decisions on patient survival.PloS one · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundOut-of-sequence (OOS) allocation is a mechanism by which donor organs are offered outside the standard match run, typically to expedite the placement of hard-to-match or time-sensitive allografts. Rising OOS rates are described in abdominal organ transplantation, but limited data exist regarding OOS practices in heart transplantation.
methodsThe United Network for Organ Sharing (UNOS) was used to identify all adult heart transplant recipients and corresponding donors between January 2015 and March 2024. The Potential Transplant Recipient file was then used to classify each donation as either in-sequence or out-of-sequence. We assessed temporal trends and practice patterns in relation to OOS allocation. Additionally, we evaluated donor and recipient characteristics and post-transplant survival outcomes.
resultsWithin the study period, there were 25,608 heart transplantations, of which 509 (2%) were from OOS donors. OOS allocation increased 2-fold over the study period (1.4%-3.1%). Use varied across Organ Procurement Organizations (OPOs) (0-5.4%) and transplant centers (0-16.7%), with a small subset of OPOs accounting for the majority of OOS allocations. Recipients of OOS-allocated allografts were more likely to be nonhospitalized older females with type O blood group. There was no significant difference in overall survival rates between OOS and in-sequence recipients at 1 year (93.1% vs 91.6%, respectively).
conclusionsOOS heart allocation, while rare, is increasing, and varies by geography and OPO. The OOS mechanism may provide an opportunity to improve organ recovery and support transplant access for harder-to-match candidates. However, standardization of OOS practices is needed to ensure equity in transplant access.
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