Work

Waitlist mortality and post transplant survival amongst non-extracorporeal membrane oxygenation high-urgency heart transplant recipients before and after the 2018 policy change

Year: 2026

Type: article

Abstract: Objective: The adult heart allocation policy changed from a 3- to 6-tiered system in 2018, more precisely stratifying high-urgency patients. Many studies examined the effects on patients classified as Status 1 or those with implantable devices, especially extracorporeal membrane oxygentation (ECMO), however, few have analyzed other high-urgency cohorts. This study's purpose is to compare waitlist and midterm outcomes of non-ECMO high-urgency patients before and after the policy change. Methods: tests, respectively. Waitlist mortality was analyzed using competing risk regression whereas Kaplan-Meier curves assessed posttransplant survival. Results: = .42) remained similar. Conclusions: Among non-ECMO high-urgency heart transplant recipients, candidates from era 2 demonstrated greater clinical acuity but improved waitlist mortality and equivalent midterm survival. These findings reassure that the 2018 policy change did not compromise outcomes amongst this high-urgency cohort, despite favoring patients bridged with ECMO.

Source: JTCVS Open

DOI: 10.1016/j.xjon.2026.101936