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OPTN/SRTR 2020 Annual Data Report: Heart
Insights
The COVID-19 pandemic impacted heart transplants in 2020, with fewer new listings but increased adult transplants. Adult post-transplant mortality shows a slight short-term rise but a long-term decrease.
Area of Science:
- Cardiology and Transplant Surgery
- Public Health and Epidemiology
Background:
- The implementation of a new adult heart allocation policy coincided with the COVID-19 pandemic.
- The pandemic presented unique challenges to organ donation and transplantation processes.
Purpose of the Study:
- To analyze the impact of the COVID-19 pandemic on heart transplant activity and outcomes.
- To evaluate trends in adult and pediatric heart transplant listings and procedures.
- To assess post-transplant mortality rates in adult and pediatric recipients.
Main Methods:
- Retrospective analysis of heart transplant data from 2019 and 2020.
- Comparison of transplant listings, procedures, and post-transplant mortality rates.
- Stratification of data by recipient age (adult vs. pediatric) and time points (6 months, 1, 3, and 5 years post-transplant).
Main Results:
- Adult heart transplants increased to 3715 in 2020, despite a slight decrease in total new listings.
- Pediatric heart transplants declined in 2020.
- Adult short-term post-transplant mortality saw a slight increase, while long-term mortality showed a downward trend.
Conclusions:
- The adult heart allocation policy and pandemic influenced transplant volumes differently for adults and pediatric recipients.
- While short-term survival post-adult heart transplant has slightly worsened, long-term outcomes continue to improve.
- Ongoing monitoring is crucial to understand the long-term effects of the policy and pandemic on heart transplantation.
Abstract:
As we enter the third year of the new adult heart allocation policy, we are faced with the new challenges of the COVID-19 pandemic. In 2020, new listings (adult and pediatric) decreased slightly, with 4000 new listings in 2020, compared with 4087 in 2019; however, the number of adult heart transplants performed continued to increase, to 3715 in 2020. The number of pediatric heart transplants declined from 509 in 2019 to 465 in 2020. One-year and six-month posttransplant mortality rates in adult recipients have increased slightly since 2015 but have not significantly changed over the past decade. Overall, posttransplant mortality rates for adult recipients were 7.4% at six months and 9.4% at one year for transplants in 2019, 14.0% at three years for transplants in 2017, and 19.1% at five years for transplants in 2015. Although shorter-term posttransplant mortality rates have slightly increased, there has been a steady downward trend in longer-term mortality. Mortality rates for pediatric recipients were 5.7% at six months and 8.1% at one year for transplants in 2019, 11.6% at three years for transplants in 2017, and 15.2% at five years for transplants in 2015.
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