Jamael Hoosain1, Shelley Hankins2,3. 1. , Philadelphia, USA. 2. , Philadelphia, USA. SRH38@drexel.edu. 3. Drexel University College of Medicine, Philadelphia, USA. SRH38@drexel.edu.
Abstract
PURPOSE OF REVIEW: Heart transplantation is the gold standard therapy for end-stage heart failure; however, the donor pool is limited, making this a scarce resource that must be allocated to the sickest patients in an efficient, fair, and equitable manner. The allocation policies have been constantly revised over the years to refine the process. We will explore the new heart allocation system, OPTN-Policy 6, as well as, review why these changes were necessary. RECENT FINDINGS: Over the past decade, the number of active heart transplant candidates nearly doubled, with a dramatic increase in the number of status 1A and 1B (high priority) candidates. Candidates have also faced increased waitlist times with geographic variances. The allocation policy changes will attempt to alleviate these problems as well as adapt to advances in technology. The new allocation policy is designed to adapt to the present day reality of expanded mechanical support use, increased candidate acuity, increasing waiting times, and geographical disparities in transplant rates. Though the implementation of the new allocation policy will require some change in practice, the transplant community, as knowledge is gained, is accustomed to change and refinement in practice, in an effort to improve outcomes for patients with end-stage heart failure.
PURPOSE OF REVIEW: Heart transplantation is the gold standard therapy for end-stage heart failure; however, the donor pool is limited, making this a scarce resource that must be allocated to the sickest patients in an efficient, fair, and equitable manner. The allocation policies have been constantly revised over the years to refine the process. We will explore the new heart allocation system, OPTN-Policy 6, as well as, review why these changes were necessary. RECENT FINDINGS: Over the past decade, the number of active heart transplant candidates nearly doubled, with a dramatic increase in the number of status 1A and 1B (high priority) candidates. Candidates have also faced increased waitlist times with geographic variances. The allocation policy changes will attempt to alleviate these problems as well as adapt to advances in technology. The new allocation policy is designed to adapt to the present day reality of expanded mechanical support use, increased candidate acuity, increasing waiting times, and geographical disparities in transplant rates. Though the implementation of the new allocation policy will require some change in practice, the transplant community, as knowledge is gained, is accustomed to change and refinement in practice, in an effort to improve outcomes for patients with end-stage heart failure.
Entities:
Keywords:
Heart Allocation Policy; Organ allocation; Organ procurement organizations; Regional review boards; The Organ Procurement and Transplantation Network; The United Network for Organ Sharing; Thoracic Organ Transplantation Committee
Authors: M Colvin-Adams; M Valapour; M Hertz; B Heubner; K Paulson; V Dhungel; M A Skeans; L Edwards; V Ghimire; C Waller; W S Cherikh; B L Kasiske; J J Snyder; A K Israni Journal: Am J Transplant Date: 2012-09-13 Impact factor: 8.086
Authors: M Colvin; J M Smith; N Hadley; M A Skeans; R Carrico; K Uccellini; R Lehman; A Robinson; A K Israni; J J Snyder; B L Kasiske Journal: Am J Transplant Date: 2018-01 Impact factor: 8.086