New research finds signal of decreased early post transplant survival in new heart transplant system

November 21, 2019

MINNEAPOLIS, MN- November 20, 2019 - In an analysis of the new heart organ allocation system for transplant patients in the U.S., researchers have identified a signal of a decrease in heart transplant survival rates. The study, "An Early Investigation of Outcomes with the 2018 Donor Heart Allocation System in the United States," is published as a rapid communication in the Journal of Heart and Lung Transplantation.

For the first time in over a decade, modifications were made to the U.S. donor heart allocation system in October of 2018, aimed at better distinguishing the most medically urgent heart transplant candidates. The old system, in place since 2005, led to overcrowding of the list, prolonged waiting times and consequent inequity in allocation across geographic regions. The new system was envisioned to allow more equitable organ allocation while providing an overall benefit to patients awaiting heart transplantation.

"This is an early trend, however, it is concerning," said lead author Rebecca Cogswell, MD, who is an assistant professor at the University of Minnesota Medical School's Department of Medicine in the Division of Cardiology and medical director of mechanical circulatory support with M Health Fairview. Cogswell and colleagues at the U of M and several institutions across the U.S., including Brigham and Women's Hospital and Harvard Medical School, undertook an early look at outcomes as a result of the new allocation system.

"This early look is similar to the kind of surveillance that occurs in large clinical trials to ensure safety," Cogswell explained.

The authors found that the changed allocation system has resulted in an increase of sicker patients being transplanted with greater frequency as intended, however, unintended consequences are emerging. Organs are being retrieved from longer distances, and fewer patients supported on durable left ventricular assist devices are receiving heart transplants in the U.S.

"The increase in mortality appears to be driven by the fact that patients who are receiving hearts are sicker than in the previous system," Cogswell reported.

The researchers found the waitlist mortality has decreased in the new system. Cogswell explained, "As waitlist mortality in the previous system was relatively low, the absolute impact of this reduction in waitlist mortality is small compared to the increase in death after transplantation that we are observing in this early examination of the new system."

"If these early observations of a substantial decline in heart transplant survival persist, and we certainly hope that they do not, several programs will be under stress for their very survival," said Mandeep R. Mehra, MD, senior author of this study, who is executive director of the Center for Advanced Heart Disease at Brigham and Women's Hospital and a professor of Medicine at Harvard Medical School.

Cogswell stated that more data will be needed to confirm these trends and to inform policy changes.

"As a community, we have a responsibility to look at this data at regular intervals to determine if we need to implement changes sooner rather than later," Cogswell emphasized.
-end-
About the University of Minnesota Medical School

The University of Minnesota Medical School is at the forefront of learning and discovery, transforming medical care and educating the next generation of physicians. Our graduates and faculty produce high-impact biomedical research and advance the practice of medicine. Visit med.umn.edu to learn how the University of Minnesota is innovating all aspects of medicine.

University of Minnesota Medical School

Related Data Articles from Brightsurf:

Keep the data coming
A continuous data supply ensures data-intensive simulations can run at maximum speed.

Astronomers are bulging with data
For the first time, over 250 million stars in our galaxy's bulge have been surveyed in near-ultraviolet, optical, and near-infrared light, opening the door for astronomers to reexamine key questions about the Milky Way's formation and history.

Novel method for measuring spatial dependencies turns less data into more data
Researcher makes 'little data' act big through, the application of mathematical techniques normally used for time-series, to spatial processes.

Ups and downs in COVID-19 data may be caused by data reporting practices
As data accumulates on COVID-19 cases and deaths, researchers have observed patterns of peaks and valleys that repeat on a near-weekly basis.

Data centers use less energy than you think
Using the most detailed model to date of global data center energy use, researchers found that massive efficiency gains by data centers have kept energy use roughly flat over the past decade.

Storing data in music
Researchers at ETH Zurich have developed a technique for embedding data in music and transmitting it to a smartphone.

Life data economics: calling for new models to assess the value of human data
After the collapse of the blockchain bubble a number of research organisations are developing platforms to enable individual ownership of life data and establish the data valuation and pricing models.

Geoscience data group urges all scientific disciplines to make data open and accessible
Institutions, science funders, data repositories, publishers, researchers and scientific societies from all scientific disciplines must work together to ensure all scientific data are easy to find, access and use, according to a new commentary in Nature by members of the Enabling FAIR Data Steering Committee.

Democratizing data science
MIT researchers are hoping to advance the democratization of data science with a new tool for nonstatisticians that automatically generates models for analyzing raw data.

Getting the most out of atmospheric data analysis
An international team including researchers from Kanazawa University used a new approach to analyze an atmospheric data set spanning 18 years for the investigation of new-particle formation.

Read More: Data News and Data 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.