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Two-year monitoring report available for the elimination of the use of DSAs in heart allocation

Published on: Tuesday, December 20, 2022

A new data report contains key measures of adult heart allocation based on policy changes implemented in January 2020. The report show that hearts are traveling slightly farther and the overall transplant rate increased post-policy, without negatively impacting total ischemic time, waiting list mortality, organ utilization, or one-year post-transplant survival.

The report notes several important trends since implementation, including:

  • The overall transplant rate increased post-policy by 13%
  • Transplant rates increased significantly post-policy for adult status 4* (38% more transplants) and adult status 6 (61% more transplants), while the transplant rate significantly decreased for adult heart status 2 (26% fewer transplants)
  • Local heart transplants decreased post-policy by 9%, while regional transplants increased post-policy by 6%, and the median travel distance for hearts increased slightly overall by three nautical miles post-policy
  • Although hearts traveled farther, there was no statistically significant change in total ischemic time, waiting list mortality, organ utilization, or one-year post-transplant survival

* Each adult heart candidate at least 18 years old is assigned a status from 1 to 6 that reflects their medical urgency for transplant. Status 1 is based on medical data that indicates the patient has the most urgent need for a transplant, while Status 6 indicates the least immediate need for transplant. For more details, see OPTN Policy 6.1 Adult Status Assignments and Update Requirements.

The policy changes were proposed by the former Organ Procurement and Transplantation Network (OPTN) Thoracic Organ Transplantation Committee, which has since split into the Heart Transplantation Committee and the Lung Transplantation Committee. The OPTN Board of Directors approved the elimination of the use of the Donor Service Area (DSA) in 2020. The OPTN Heart Transplantation Committee will continue to monitor this policy as data is submitted, and subsequent monitoring reports will be published on the OPTN website on an ongoing basis.

Read the one-year monitoring report for this policy change and other reports here.