Prognostic Value of Ambulatory Status at Transplant in Older Heart Transplant Recipients: Implications for Organ Allocation Policy
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Shortage of organ donors in the Republic of Korea has become a major problem. To address this, it has been questioned whether heart transplant (HTx) allocation should be modified to reduce priority of older patients. We aimed to evaluate post-HTx outcomes according to recipient age and specific pre-HTx conditions using a nationwide prospective cohort. METHODS: We analyzed clinical characteristics of 628 patients from the Korean Organ Transplant Registry who received HTx from January 2015 to December 2020. Enrolled recipients were divided into three groups according to age. We also included comorbidities including ambulatory status. Non-ambulatory status was defined as pre-HTx support with either extracorporeal membrane oxygenation, continuous renal replacement therapy, or mechanical ventilation. RESULTS: = 0.465). CONCLUSION: Our results do not support use of age alone as an allocation criterion. Transplant candidate age in combination with some comorbidities such as non-ambulatory status may identify patients at a sufficiently elevated risk at which suitability of HTx should be reconsidered.
Authors: Junho Hyun, Jong-Chan Youn, Jung Ae Hong, Darae Kim, Jae-Joong Kim, Myoung Soo Kim, Jaewon Oh, Jin-Jin Kim, Mi-Hyang Jung, In-Cheol Kim, Sang-Eun Lee, Jin Joo Park, Min-Seok Kim, Sung-Ho Jung, Hyun-Jai Cho, Hae-Young Lee, Seok-Min Kang, Dong-Ju Choi, Jon A. Kobashigawa, Josef Stehlik, Jin-Oh Choi
Institutions: Asan Medical Center, University of Ulsan, The Catholic University of Korea Seoul St. Mary's Hospital, Catholic University of Korea, Samsung Medical Center, Sungkyunkwan University, Yonsei University, Yonsei University Health System, Severance Hospital, Keimyung University Daegu Dongsan Hospital, Keimyung University Dongsan Hospital, Keimyung University, Seoul National University, Seoul National University Bundang Hospital, Seoul National University Hospital, Cedars-Sinai Medical Center, Cedars-Sinai Smidt Heart Institute, University of Utah
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $690
OpenAlex ID: W4404126674
