Proceedings of the AST heart allocation meeting at the American Transplant Congress, Philadelphia, Pennsylvania, May 4, 2015. Issue 5 (22nd March 2016)

• Record Type: Journal Article
• Authors: Kobashigawa, Jon; Teuteberg, Jeffrey; Colvin, Monica; Edwards, Leah; Daun, Tiffany; Luu, Minh; Patel, Jignesh; Vega, John David; Meyer, Dan
• Other Names: Ardehali Abbas investigator.; Bhat Geetha investigator.; Baran David investigator.; Couper Gregory investigator.; Czer Lawrence investigator.; Esmailian Fardad investigator.; Fischer Wade investigator.; Gollnick Megan investigator.; Halnon Nancy investigator.; Johnson Malissa investigator.; Kao Tina investigator.; Kearney‐Hoffman Peggy investigator.; Kessler Lynn investigator.; Khush Kiran investigator.; Mone Thomas investigator.; Peltz Matthias investigator.; Pinney Sean investigator.; Pisani Barbara investigator.; Pyke Josh investigator.; Rajapreyar Indranee investigator.; Robbins‐Callahan Liz investigator.; Schladt David investigator.; Shullo Michael investigator.; Schulte Kristine investigator.; Skeans Melissa investigator.; Sieg Adam investigator.; Simones Brooke investigator.; Sorensen Anna investigator.; Stehlik Josef investigator.; Taylor David investigator.; Toyoda Yoshiya investigator.; Velleca Angela investigator.; Wong Janet investigator.; Zeglin Jessica investigator.;
• Is Part Of: Clinical transplantation. Volume 30:Issue 5(2016)
• Page Start: 641
• Page End: 648
• Publication Date: 2016-03-22
• Subjects: cardiac transplantation -- exceptions -- heart allocation -- mechanical circulatory support -- policy -- sensitized patients; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12717
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Ensuring fair and equitable allocation of donor hearts in the US is the charge of the Organ Procurement and Transplantation Network (OPTN). However, the recent increase of candidates waiting without a corresponding increase in available donors, higher waitlist mortality rates in higher status patients, the presence of disadvantaged subgroups, and the changing management of heart failure patients with increased VAD usage, has necessitated review of allocation policy. Therefore, the Heart Subcommittee of the OPTN/UNOS Thoracic Committee is exploring a further‐tiered allocation system, devising a "straw man" model as a starting point for modeling analyses and public discussion. On May 4, 2015, an American Society of Transplantation (AST)‐endorsed forum to discuss these potential proposed changes took place. Attendees included 41 people, mostly highly experienced transplant cardiologists and cardiothoracic surgeons, representing 19 heart transplant centers across the US, UNOS, and the Scientific Registry of Transplant Recipients (SRTR). There was unanimous agreement that the potential proposed policy will require careful wording to avoid ambiguity and "gaming" of the system, and strong support for abolishment of local organ sharing in favor of geographic sharing. However, contention existed concerning the appropriate prioritization levels of ECMO, temporary VAD/TAH patients as well as the 30‐day LVAD listing.