scholarly journals Outcomes of the First 1300 Adult Heart Transplants in the United States After the Allocation Policy Change

Circulation ◽  
2020 ◽  
Vol 141 (20) ◽  
pp. 1662-1664 ◽  
Author(s):  
Arman Kilic ◽  
Gavin Hickey ◽  
Michael A. Mathier ◽  
Robert L. Kormos ◽  
Ibrahim Sultan ◽  
...  
Keyword(s):  
United States ◽  
Policy Change ◽  
The United States ◽  
Heart Transplants ◽  
Allocation Policy ◽  
Adult Heart

scholarly journals Changes in the United States Adult Heart Allocation Policy

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Supriya Shore ◽  
Jessica R. Golbus ◽  
Keith D. Aaronson ◽  
Brahmajee K. Nallamothu
Keyword(s):  
United States ◽  
The United States ◽  
Allocation Policy ◽  
Adult Heart

Pediatric heart transplant waiting times in the United States since the 2016 allocation policy change

2021 ◽  
Author(s):  
Ryan J. Williams ◽  
Minmin Lu ◽  
Lynn A. Sleeper ◽  
Elizabeth D. Blume ◽  
Paul Esteso ◽  
...  
Keyword(s):  
United States ◽  
Policy Change ◽  
Heart Transplant ◽  
Waiting Times ◽  
The United States ◽  
Allocation Policy ◽  
Pediatric Heart Transplant

Abstract 15953: Impact of Citizenship on Heart Transplantation Outcomes in the United States

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Allison P Levin ◽  
Thomas C Hanff ◽  
Robert S Zhang ◽  
Rhondalyn C McLean ◽  
Joyce W Wald ◽  
...  
Keyword(s):  
United States ◽  
Heart Transplant ◽  
Transplant Rejection ◽  
The United States ◽  
Heart Transplants ◽  
Allocation Policy ◽  
Transplant Survival ◽  
Post Transplant ◽  
Significant Difference ◽  
Face Complex

Background: Non-citizens of the United States face complex social and economic issues, which may impact their post-transplant outcomes compared to US citizens. To this end, we utilized the United Network for Organ Sharing (UNOS) database to examine post-heart transplant (OHT) outcomes, stratified by citizenship status. Methods: UNOS was queried to identify OHT recipients from 03/01/12 (start of new schema for citizenship categorization) through 10/18/18 (start of new heart allocation algorithm). Groups for analysis, were as follows: US Citizen, Non-US Citizen/Resident (NC-R) and Non-US Citizen/Non-US Resident (NC-NR). Post-transplant survival and rate of post-transplant rejection were assessed via Kaplan-Meier analysis and tests of proportions. Results: Of the 16,211 OHT recipients identified, 15,677 (96.7%) were US citizens and 534 (3.3%) were Non-Citizens. Among Non-Citizens, 430 were NC-R and 104 were NC-NR, representing 2.7% and 0.6% of the total transplants. Notably, NC-NR were younger than either Citizens or NC-R, and had the shortest median time from listing to transplant (NC-R 80 days vs. Citizens 107 days vs. NC-NR 76 days, p=0.001). The proportion of transplants received by non-citizens varied widely by region, ranging from 0.59% in region 8 (6/1018) to 8.31% (84/1011) in region 9. There was no significant difference in post-transplant survival estimates in citizens vs. non-citizens (logrank p = 0.542), nor in the proportion of patients treated for rejection by one year (15.0% vs. 16.1%, p= 0.504) Conclusion: Non-US Citizens receive three percent of heart transplants performed in the US each year. Post-heart transplant survival and rate of rejection are similar in US citizens and non-citizens. These data may be relevant in the context of evolving UNOS policies. Additional studies are needed are to further inform organ allocation policy.

Emerging Trends in Financing of Adult Heart Transplantation in the United States

2019 ◽  
Vol 7 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Ersilia M. DeFilippis ◽  
Muthiah Vaduganathan ◽  
Sara Machado ◽  
Josef Stehlik ◽  
Mandeep R. Mehra
Keyword(s):  
United States ◽  
Heart Transplantation ◽  
The United States ◽  
Adult Heart ◽  
Emerging Trends

Impact of Coronavirus-2019 on Pediatric and Adult Heart Transplantation Waitlist Activity and Mortality in the United States: A Descriptive Approach

2021 ◽  
Author(s):  
Awais Ashfaq ◽  
Goeffrey M. Gray ◽  
Jennifer Carapellucci ◽  
Ernest K. Amankwah ◽  
Luis M. Ahumada ◽  
...  
Keyword(s):  
United States ◽  
Heart Transplantation ◽  
The United States ◽  
Adult Heart ◽  
Descriptive Approach

scholarly journals Evolving Trends in Adult Heart Transplant With the 2018 Heart Allocation Policy Change

2020 ◽  
Author(s):  
Arman Kilic ◽  
Michael A. Mathier ◽  
Gavin W. Hickey ◽  
Ibrahim Sultan ◽  
Victor O. Morell ◽  
...  
Keyword(s):  
Policy Change ◽  
Heart Transplant ◽  
Allocation Policy ◽  
Adult Heart

scholarly journals Unintended Consequences of the New National Kidney Allocation Policy in the United States

2015 ◽  
Vol 15 (9) ◽  
pp. 2465-2469 ◽  
Author(s):  
A. R. Tambur ◽  
K. M. K. Haarberg ◽  
J. J. Friedewald ◽  
J. R. Leventhal ◽  
M. F. Cusick ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Unintended Consequences ◽  
Allocation Policy ◽  
Kidney Allocation

Predicting Policy Change in the House: A Longitudinal Analysis

1982 ◽  
Vol 12 (3) ◽  
pp. 375-384
Author(s):  
Patricia A. Hurley
Keyword(s):  
United States ◽  
Public Policy ◽  
Policy Change ◽  
Longitudinal Analysis ◽  
The United States ◽  
Interactive Effects ◽  
Policy Changes ◽  
Number Of Factors

If one were asked to describe the process of policy change in the United States in one word, that word would surely be ‘incremental’. Students of the Congressional process can point to a number of factors which account for delay in changes of policy; it is only recently that they have begun to examine the occasional departures from Congressional intractability in matter of public policy. This paper seeks to further our understanding of how internal legislative conditions can produce or inhibit policy change. While the first scholars to call attention to this phenomenon noted that policy changes followed critical realignments, others have made a more general case for the ability of Congress to pass important legislation, arguing that Congressional potential for policy change depends largely upon the interactive effects of both majority and minority size and unity. Policy changes have been enacted by those Congresses with large and/or cohesive majorities and small and/or disorganized minorities. These conditions often follow realigning elections, but occur at other times as well.

A Critique of UNOS Liver Allocation Policy

1999 ◽  
Vol 8 (3) ◽  
pp. 311-320 ◽  
Author(s):  
KENNETH EINAR HIMMA
Keyword(s):  
United States ◽  
Liver Disease ◽  
Liver Failure ◽  
Chronic Liver Disease ◽  
The United States ◽  
Acute Illness ◽  
Waiting List ◽  
Allocation Policy ◽  
Liver Allocation ◽  
United Network

The United Network for Organ Sharing (UNOS) recently changed the policy by which donor livers are allocated to liver failure patients in the United States. Formerly, all liver failure patients were characterized as status 1 and placed at the top of the transplant list. Under the new policy, only patients with liver failure due to acute illness (“ALF patients”) are eligible for status 1; patients with liver failure due to chronic liver disease (“CLF patients”) are characterized as status 2. Since donor organs are allocated first to status 1 patients and then to status 2 patients, the new policy moves all CLF patients down on the waiting list relative to all ALF patients. This means that some livers that would have gone to CLF patients under the old policy will now go to ALF patients. Accordingly, while the new policy will likely increase the number of ALF patients saved, it will also increase the number of deaths among CLF patients waiting for a transplant.

Sign in / Sign up

Export Citation Format

Share Document