Journal
AMERICAN JOURNAL OF TRANSPLANTATION
Volume 22, Issue -, Pages 350-437Publisher
WILEY
DOI: 10.1111/ajt.16977
Keywords
End-stage heart failure; heart transplant; transplant outcomes; ventricular assist device
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This article discusses the challenges faced in the third year of the new adult heart allocation policy in light of the COVID-19 pandemic. It provides data on the number of new listings, adult and pediatric heart transplants performed, and posttransplant mortality rates. While there has been a slight increase in short-term mortality rates, there is a steady downward trend in longer-term mortality.
As we enter the third year of the new adult heart allocation policy, we are faced with the new challenges of the COVID-19 pandemic. In 2020, new listings (adult and pediatric) decreased slightly, with 4000 new listings in 2020, compared with 4087 in 2019; however, the number of adult heart transplants performed continued to increase, to 3715 in 2020. The number of pediatric heart transplants declined from 509 in 2019 to 465 in 2020. One-year and six-month posttransplant mortality rates in adult recipients have increased slightly since 2015 but have not significantly changed over the past decade. Overall, posttransplant mortality rates for adult recipients were 7.4% at six months and 9.4% at one year for transplants in 2019, 14.0% at three years for transplants in 2017, and 19.1% at five years for transplants in 2015. Although shorter-term posttransplant mortality rates have slightly increased, there has been a steady downward trend in longer-term mortality. Mortality rates for pediatric recipients were 5.7% at six months and 8.1% at one year for transplants in 2019, 11.6% at three years for transplants in 2017, and 15.2% at five years for transplants in 2015.
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