Global strategies to improve equitable access to heart and lung transplantation- ISHLT Consortium Report
Year: 2026
Type: review
Abstract: Background: Many inequities exist in the global access of heart and lung transplantation. Few studies have identified global strategies to implement equitable access to heart or lung transplantation. Methods: Members of the International Society for Heart and Lung Transplantation (ISHLT) developed a consortium to identify strategic priorities to improve global access to heart and lung transplantation according to the Capability, Opportunity, Motivation- Behavior Change Wheel Model (COM-B/ BCW), an implementation science framework. Initial workshops were held at the ISHLT Scientific Sessions and refined with follow-up focus group meetings of consortium members from 2025 through 2026. Results: Focus 1 was to improve quality of transplant data for access and outcomes; prioritized behavior included: 1) improving collection of social determinants of health, race, and ethnicity data, and 2) collecting data on patients referred but not listed. Focus 2 was to improve transplant access to diverse racial and ethnic populations; prioritized behavior included: 1) increasing transparency regarding candidacy and allocation, and 2) improving awareness regarding diverse patient and community needs for transplant consideration. Focus 3 was to improve access with patient-centered approaches; prioritized behavior included: individualizing a comprehensive patient assessment and plan. Focus 4 was to develop transplant programs in under-resourced countries; prioritized behaviors included: 1) developing a national or regional heart and lung transplant infrastructure and workforce plan, and 2) identifying and designating transplant capable centers as pilot hubs or consortium nodes. Conclusions: An ISHLT consortium developed and prioritized strategies for behavior change to improve global access to heart and lung transplantation. These strategies may form the basis of global quality improvement and implementation research studies for transplantation equity.
Source: JHLT Open
Authors: Khadijah Breathett, Johanna Contreras, Sabra Lewsey, Alessandra Agnese Grossi, Kyung-Hee Kim, Ainur Akilzhanova, Olawale Amubieya, Nicholas Avdimiretz, Abigail Boyle, Leanne Duhaney, Cesar Guerrero, Onyedika Ilonze, Holly Keyt, Jake Kleinmahon, Juan Carlos Leoni Moreno, Lorena Montes, Matthew Montgomery, Andrew Morley-Smith, Franziska Olm, Jyotika Prasad, Saule Rakhimova, Leslie Seijo, Luciano Potena
Institutions: Indiana University Indianapolis, Johns Hopkins University, Johns Hopkins Medicine, University of Insubria, Nazarbayev University, University of California, Los Angeles, University of British Columbia, BC Children's Hospital, Cystic Fibrosis Foundation, Boston Children's Hospital, Baylor University Medical Center, The University of Texas at San Antonio Health Science Center, Northwell Health, Hofstra University, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Mayo Clinic, Mayo Clinic in Florida, Fundación Cardiovascular de Colombia, Newark Beth Israel Medical Center, Jersey City Medical Center, Harefield Hospital, Lund University, The Alfred Hospital, University of California, San Francisco, University of Bologna
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,500
OpenAlex ID: W7202160171