Evidence map›Paper›PMID 42161027›Full record

ArticleJACC. Advances2026

Sex Differences in Heart Transplantation Outcomes: A 5-Year Review of the 2018 U.S. Allocation Policy.

Bhavadharini Ramu, Maria Masotti, Jessica Schultz, Valmiki Maharaj, Tamas Alexy, Michael Mulvihill, K Joshua Wong, Tessa M F Watt, Andrew Shaffer, Ranjit John and 1 more

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Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Bhavadharini RamuDivision of Cardiology, University of Minnesota, Minneapolis, Minnesota, USA. Electronic address: bramu@umn.edu.
Maria MasottiHennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.
Jessica SchultzDivision of Cardiology, University of Minnesota, Minneapolis, Minnesota, USA.
Valmiki MaharajDivision of Cardiology, University of Minnesota, Minneapolis, Minnesota, USA.
Tamas AlexyDivision of Cardiology, University of Minnesota, Minneapolis, Minnesota, USA.
Michael MulvihillDivision of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
K Joshua WongDivision of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Tessa M F WattDivision of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Andrew ShafferDivision of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Ranjit JohnDivision of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Rebecca CogswellDivision of Cardiology, University of Minnesota, Minneapolis, Minnesota, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe U.S. heart transplant (HT) allocation policy was revised in 2018 with known sex differences in short-term outcomes; however, whether these translate to longer-term outcomes are unknown.

objectivesThe authors sought to investigate long-term sex-specific waitlist and post-HT outcomes following this policy change.

methodsWaitlist cohort: Adults (≥18 years) listed for first-time, single-organ HT were identified using the United Network for Organ Sharing Registry between October 18, 2018, and October 17, 2023. Multivariable Fine-Gray competing risk analyses assessed: 1) rates of HT and 2) delisting due to death or clinical deterioration by sex. Transplant cohort: over the same time period, survival of first-time single-organ, HT recipients was analyzed by sex using multivariable Cox regression.

resultsAmong 15,422 waitlist candidates since 2018 (26.3% women), women had a higher rate of HT than men (adjusted subdistribution HR (aSHR): 1.24; 95% CI: 1.18-1.31; P < 0.001) and lower rate of delisting for death or clinical deterioration (aSHR: 0.81; 95% CI: 0.70-0.94; P = 0.005). Among 12,892 HT recipients (27.4% women), women had a higher adjusted post-HT mortality than men at 1-year and 5-years of follow-up (aHR: 1.14; 95% CI: 1.02-1.28; P = 0.019 and aHR:1.14; 95% CI: 1.02-1.27; P = 0.021, respectively).

conclusionsFive years after implementation of the 2018 allocation policy, women have higher rates of HT and lower delisting due to death or clinical deterioration as compared to men with lower long-term post-HT survival.

Indexed as

heart transplantationsex differenceswomen

Identifiers

PMID42161027
PMCPMC13217583

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