Work

Under-Capture of Candidates Supported by Temporary Mechanical Circulatory Support in the OPTN STAR Registry

Year: 2026

Type: article

Abstract: We read with interest the study by Cyrille-Superville et al 1 examining sex-specific trends in temporary mechanical circulatory support (MCS) use as a bridge to heart transplantation using the Standard Transplant Analysis and Research (STAR) registry from the Organ Procurement and Transplantation Network (OPTN).We commend the authors for this important contribution but wish to raise a methodological concern regarding the data source.Heart transplant programs submit MCS device information to the OPTN through multiple instruments.Between initial listing and waitlist removal, programs report MCS use through status justification forms to document ongoing device support.They also submit MCS removal forms when candidates are taken off of the waitlist.The supplemental MCS file in the STAR registry is constructed exclusively from the removal forms, capturing device status only for candidates who have exited theFIGURE 1 Retroactive Ascertainment of Temporary MCS-Supported Adult Candidates (A) Shows the month of temporary MCS placement for all 2,611 adult candidates identified using a December 31, 2025, data extraction with temporary MCS (IABP, nondischargeable or percutaneous LVAD, TAH, VA ECMO) placed between December 1, 2023, and November 30, 2024.(B) Shows the month of waitlist removal for the same cohort.Patients captured in the December 31, 2024, extraction (N = 2,533) are shown in blue.Patients missing from the December 2024 extraction (N = 78) are shown in red.All 78 missing patients had active temporary MCS support prior to December 31, 2024, but appeared in the STAR MCS file only after being removed from the waitlist in 2025.The dashed vertical line denotes the data extraction date (December 31, 2024).MCS = mechanical circulatory support.

Source: JACC Advances

DOI: 10.1016/j.jacadv.2026.103213

Authors: Daniel J. Ahn, Antony Attia, Toshihiro Nakayama, William F. Parker, Kiran K. Khush

Institutions: Stanford Cardiovascular Institute, Stanford University, Stanford Medicine, University of Chicago

Language: English

Topic: Mechanical Circulatory Support Devices

Subfield: Biomedical Engineering

Field: Engineering

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,936