Yale succeeds with a more inclusive approach to heart transplants

September 18, 2020

New Haven, Conn. -- Doctors at Yale New Haven Hospital used a more aggressive selection process to more than quadruple the number of heart transplants performed there while maintaining positive patient outcomes, according to a new study.

The findings suggest that a more inclusive approach to selecting donor hearts and transplant recipients can enable hospitals to successfully treat more patients in need of transplants. The study appears online Sept. 18 in the journal JAMA Network Open.

The study looked at short-term patient outcomes for two groups: 49 patients who received heart transplants from 2014 to 2018, and 58 patients who had their heart transplants in the year after the hospital adopted a more aggressive selection process for donor recipients (2018-2019).

The more aggressive selection process significantly shortened the waiting period for heart patients, from 242 days to 41 days, the researchers said. Importantly, patients' survival rate at 180 days after the transplant remained nearly unchanged.

The expansion of heart transplant procedures at the hospital, in September 2018, coincided with the implementation of the new United Network for Organ Sharing (UNOS) donor heart allocation system in the United States.

"I think this is the takeaway for other centers -- that such a change in the approach could create opportunities for patients in need while maintaining outcomes in the short term," said Makoto Mori, M.D., a surgical resident at Yale and first author of the study.

The senior author of the study was Harlan Krumholz, M.D., the Harold H. Hines Jr. Professor of Medicine (cardiology) and director of Yale's Center for Outcomes Research and Evaluation.

In practical terms, the expansion of heart transplant procedures at Yale New Haven Hospital meant accepting hearts from older donors with additional medical conditions, as well as accepting transplant recipients with more severe illnesses.

Yale New Haven Hospital also changed the surgical leadership of its advanced heart failure program, hired a dedicated procurement surgeon and an additional transplant coordinator, and increased the involvement of surgical attending physicians.

The researchers noted that Yale's increase in heart transplant cases was significantly larger than the volume change seen at other heart transplant centers in the same region during the same period, including Hartford Hospital, Tufts Medical Center, Brigham and Women's Hospital, and Massachusetts General Hospital.

"We used a multidisciplinary approach and made strategic changes in donor and recipient selection, which allowed us to increase the number of heart transplants performed and therefore help more patients with advanced heart failure in a safe and an effective manner," said co-author Arnar Geirsson, M.D., chief of cardiac surgery at Yale New Haven Hospital.

Co-authors of the study were Lynn Wilson, Tariq Ahmad, Muhammad Anwer, and Daniel Jacoby, all of Yale; and Ayyaz Ali of Hartford Hospital.
-end-


Yale University

Related Transplant Recipients Articles from Brightsurf:

Are organ transplant recipients at greater risk of death from COVID-19?
A new study analyzes death risk from COVID-19 in organ transplant recipients and finds one treatment method greatly increased the risk.

Experts issue back-to-school guidelines for pediatric solid organ transplant recipients
As school districts look ahead to a very different school year, pediatric infectious disease experts from across the United States convened to outline back-to-school safety guidelines for solid organ transplant (SOT) recipients.

Racial, gender disparities observed in heart transplant recipients with COVID-19 infection
Researchers suggest focusing on disparities to help identify which patients with a heart transplant may be at higher risk for a worse course of COVID-19 infection.

Characteristics, outcomes of heart transplant recipients with COVID-19
The characteristics, treatment and outcomes of heart transplant recipients who were infected with COVID-19 in New York City are described in this case series.

Advanced liver disease patients and transplant recipients need specific care during COVID-19
The European Association for the Study of the Liver (EASL) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) have issued a Position Paper, providing recommendations for clinicians caring for patients with liver diseases during the current pandemic.

City of Hope's Triplex vaccine reduces rate of CMV complications in transplant recipients
Patients who underwent a stem cell transplant and received the Triplex vaccine to prevent a type of herpes virus -- cytomegalovirus (CMV) -- from duplicating out of control were 50% less likely to develop health complications related to the virus than patients who did not take Triplex, according to a City of Hope-led study published today in Annals of Internal Medicine.

Mediterranean diet may help preserve the kidney health of transplant recipients
In a study of kidney transplant recipients, those with higher adherence to the Mediterranean diet were less likely to experience kidney function loss.

Study finds racial disparities in pregnancy rates for kidney transplant recipients
Research from the University of Cincinnati finds that among women who are kidney transplant recipients, Hispanic women have a higher likelihood of pregnancy than white women.

Researchers remove the need for anti-rejection drugs in transplant recipients
For decades, immunologists have been trying to train the transplant recipient's immune system to accept transplanted cells and organs without the long-term use of anti-rejection drugs.

Long-term islet transplant recipients show near-normal glucose control
Findings from continuous glucose monitoring evaluations in islet transplant recipients who have been insulin independent for an average of 10 years show near normal glycemic profiles and time-in-range metrics, demonstrating that islet transplantation can be a successful long-term therapy for select patients with type 1 diabetes.

Read More: Transplant Recipients News and Transplant Recipients Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.