ArticleJHLT open2026
Changes in disparities in access and outcomes in heart transplantation among adults with congenital heart disease following the 2018 OPTN allocation policy.
Article in JHLT open, 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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Abstract
Background: Disparities in heart transplant (HT) outcomes for patients with social drivers of health (SDOH) and adult congenital heart disease (ACHD) are undefined. Methods: The Organ Procurement and Transplant Network (OPTN) database was queried for patients ≥18 years of age with a CHD diagnosis listed for HT from 2013 to 2023. Sociodemographic variables and SDOH including a neighborhood socioeconomic status (SES) score and distance to listing center were noted. Outcomes included waitlist time, waitlist mortality, and 1-year post-HT mortality. Patients were divided based on listing before or after the 2018 allocation change. A stratified analysis by era was performed for each outcome using a competing risk model for waitlist mortality and delisting, and logistic regression for 1-year post-HT mortality. Results: After 2018 ( Conclusion: Disparities in HT outcomes for ACHD patients with SDOH have improved following the 2018 OPTN allocation change. Distance from transplant care may be a risk factor for early post-HT mortality.
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