Changes in United States heart allocation: A community energized to improve policy

Area of Science:

• Cardiology
• Transplant Surgery
• Health Policy

Background:

• Current donor heart allocation in the U.S. has not kept pace with evolving patient demographics and medical advancements.
• Increasing numbers of patients with advanced heart failure face limited donor availability and regional disparities in access to care.

Purpose of the Study:

• To address the stagnation in donor heart allocation by re-evaluating patient prioritization and organ sharing protocols.
• To propose a new policy that enhances equity and efficiency in the heart transplant waiting list process.

Main Methods:

• The United Network for Organ Sharing (UNOS) Thoracic Committee reviewed existing allocation criteria and patient data.
• A new policy was developed to stratify patients more granularly based on wait-list mortality risk.
• The policy proposes expanding geographic boundaries for organ sharing.

Main Results:

• The proposed policy introduces a more refined patient stratification system.
• It aims to increase access to donor hearts for the sickest patients on the waiting list.
• The policy seeks to mitigate regional disparities in heart transplantation.

Conclusions:

• The revised UNOS policy is designed to improve donor heart allocation by prioritizing patients based on their immediate need and risk of mortality.
• Expanding organ sharing regions is a key component to ensure equitable access for critically ill heart failure patients awaiting transplantation.