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OPTN/SRTR 2022 Annual Data Report: Heart.

Monica M Colvin1, Jodi M Smith2, Yoon Son Ahn3

  • 1Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN; Department of Cardiology, University of Michigan, Ann Arbor, MI.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
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PubMed
Summary

Heart transplant numbers are rising for both adults and children, with improved survival rates. However, pediatric transplant rates have declined, and pre-transplant mortality remains high for infants.

Keywords:
Allocationdonorheart failureheart transplantleft ventricular assist devicemechanical circulatory supportoutcomes

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Area of Science:

  • Cardiovascular Medicine
  • Transplantation Surgery
  • Public Health Trends

Background:

  • The number of heart transplants in the United States has significantly increased since 2011.
  • Both pediatric and adult heart transplant candidate numbers have also risen substantially.
  • Favorable donor trends include increased heart recovery and procurement after circulatory death.

Purpose of the Study:

  • To analyze trends in heart transplantation for pediatric and adult candidates in the U.S. from 2011 to 2022.
  • To evaluate changes in transplant rates, pre-transplant mortality, and post-transplant survival.
  • To assess the impact of donor trends on heart transplantation outcomes.

Main Methods:

  • Analysis of national heart transplant data from 2011 to 2022.
  • Calculation of transplant rates per 100 patient-years for pediatric and adult populations.
  • Evaluation of pre-transplant and post-transplant mortality and survival rates.

Main Results:

  • Adult heart transplants increased by 85.8% and pediatric by 31.7% between 2011 and 2022.
  • Adult transplant rates peaked at 122.5 per 100 patient-years, while pediatric rates decreased to 104.2.
  • Pre-transplant mortality declined significantly for both groups, but remains high for infants (<1 year).

Conclusions:

  • While overall heart transplantation is increasing with better survival, a decline in pediatric transplant rates is concerning.
  • Continued efforts are needed to address the high pre-transplant mortality in the youngest pediatric candidates.
  • Positive donor trends support the ongoing expansion of heart transplant programs.