OPTN/SRTR 2020 Annual Data Report: Heart

Abstract

As we enter the third year of the new adult heart allocation policy, we are faced with the new challenges of the COVID-19 pandemic. In 2020, new listings (adult and pediatric) decreased slightly, with 4000 new listings in 2020, compared with 4087 in 2019; however, the number of adult heart transplants performed continued to increase, to 3715 in 2020. The number of pediatric heart transplants declined from 509 in 2019 to 465 in 2020. One-year and six-month posttransplant mortality rates in adult recipients have increased slightly since 2015 but have not significantly changed over the past decade. Overall, posttransplant mortality rates for adult recipients were 7.4% at six months and 9.4% at one year for transplants in 2019, 14.0% at three years for transplants in 2017, and 19.1% at five years for transplants in 2015. Although shorter-term posttransplant mortality rates have slightly increased, there has been a steady downward trend in longer-term mortality. Mortality rates for pediatric recipients were 5.

Global challenges in left ventricular assist device therapy: a tale across two continents

“…9 The majority of LVAD implants are now designated as indicated for lifetime use in the US. 7,9,10 In sharp contrast, the advanced HF therapy landscape has been relatively stable in Europe during this time period. The number of HT cases in the Eurotransplant region has been constant and as in the past, unable to keep pace with the increasing need for donor organs in the advanced HF patient population.…”

“…A US policy change in 2018 in the national heart allocation system precipitously reduced bridge use of LVADs in exchange for an increase in the use of temporary mechanical circulatory support in candidates awaiting HT 9 . The majority of LVAD implants are now designated as indicated for lifetime use in the US 7,9,10 . In sharp contrast, the advanced HF therapy landscape has been relatively stable in Europe during this time period.…”

“…Innovation and expansion in donor organ procurement and utilization (propelled by the use of substance abuse related and hepatitis C viremic donors, donation after circulatory death and ex-situ perfusion) has stimulated an increase in HT. 7,8 A US policy change in 2018 in the national heart allocation system precipitously reduced bridge use of LVADs in exchange for an increase in the use of temporary mechanical circulatory support in candidates awaiting HT. 9 The majority of LVAD implants are now designated as indicated for lifetime use in the US.…”

Cancer Risk and Mutational Patterns Following Organ Transplantation

“…Over the same period, pancreatic and intestinal transplants dropped 21% and 49%, respectively. The demand for transplants continues to rise ( Colvin et al, 2022 ; Horslen et al, 2022 ; Israni, 2022 ; Kandaswamy et al, 2022 ; Kwong et al, 2022 ; Lentine et al, 2022 ; Valapour et al, 2022 ).…”

Bench valvular surgery in donor's hearts before transplantation: Choice versus necessity

“…As a result, many patients die waiting for donors. According to the 2020 Organ Procurement and Transplantation Network/Scientific Registry of Transplant Recipients report, the overall mortality rate among patients on the heart waitlist in the USA was 9 per 100 waitlist years, and status 1A patients had a pretransplant mortality rate of 29.5 deaths per 100 waitlist years 2 . To alleviate the death on the waitlist, efforts have been focused on expanding the donor pool by multiple approaches, including the expansion of the donor criteria.…”