Data show marked decrease in heart transplant waiting list mortality after OPTN policy change

Published on: Friday, February 22, 2008

Orlando, FL -- Early data shared at the OPTN/UNOS Board of Directors Meeting Feb. 21 indicated that waiting list deaths among heart transplant candidates have dramatically decreased since a 2006 OPTN policy change in the sequence of heart allocation.

"There have not been major changes in the makeup of the heart waiting list in the periods before or after the policy change," said Dr. David Vega, chair of the OPTN/UNOS Thoracic Organ Transplantation Committee. "But we have seen a significant decrease in waiting list mortality among the two most medically urgent groups of heart candidates -- Status 1A and Status 1B. There has even been a decrease in wait list deaths among Status 2 candidates. This suggests the new policy is producing the desired results."

The revised policy, implemented in July 2006, gave more immediate priority to Status 1A and 1B heart candidates at centers within a 500-mile radius of the donor site. Additional, but lower, priority was also given to urgent candidates at centers between 500 and 1000 miles of the donor's location.

Dr. Vega presented data for 12-month periods before and after the policy's implementation. Deaths as a function of time waited on the list (deaths per 100 patient-years) decreased threefold for the most urgent (Status 1A) candidates, from 96.3 before implementation to 30.3 afterward. Deaths among Status 1B candidates were cut nearly in half, from 20.3 to 11.8. Deaths among Status 2 patients also decreased slightly, from 5.8 to 3.7.

"It's still too early to assess the policy's long-term result and how it affects post-transplant survival," said Dr. Vega. "But we will continue to study the policy's effects and make any changes that could further improve outcomes."

The Organ Procurement and Transplantation Network (OPTN) is operated under contract with the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Transplantation by the United Network for Organ Sharing (UNOS). The OPTN brings together medical professionals, transplant recipients and donor families to develop organ transplantation policy.