Organ allocation in adults with congenital heart disease listed for heart transplant: impact of ventricular assist devices.

Adults with congenital heart disease (CHD) listed for heart transplantation are rarely supported by ventricular assist devices (VADs). This may be a disadvantage to their priority for organ allocation. We sought to determine the relationship between VAD implantation and successful transplantation among patients listed for heart transplant. Adults with CHD patients (N = 1,250) were identified from the United Network for Organ Sharing (UNOS) database from 1985 to 2010 and compared to patients without congenital etiology for heart failure (N = 59,606). VAD use at listing, listing status, status upgrades and reasons for upgrade prior to transplant were trended at 5-year intervals and appropriate statistical comparisons were made between groups. Since 1985, VAD use prior to transplant has increased significantly in patients without CHD, but not in CHD patients (17% vs 3% in 2006 to 2010, p < 0.0001). CHD patients were more likely to be listed as Status 2, compared to those without (66% vs 40%, p < 0.001 for 2006 to 2010), and less likely to be upgraded to Status 1 after listing (43% vs 55%, p = 0.03). Among those upgraded to Status 1, CHD patients were less likely to have a VAD at transplant than those without (3% vs 18%, p = 0.005). VAD use was more likely to result in death in CHD patients. VAD use is less common in CHD patients than in patients without CHD, both at the time of listing and transplantation. Reduced VAD use appears to contribute to lower listing status and organ allocation. These differences have grown more disparate over time. Separate criteria for organ allocation for CHD patients may be justified.

Gelow JM ，Song HK ，Weiss JB ，Mudd JO ，Broberg CS ... -  《-》

Effects of the 2006 U.S. thoracic organ allocation change: analysis of local impact on organ procurement and heart transplantation.

Nativi JN ，Kfoury AG ，Myrick C ，Peters M ，Renlund D ，Gilbert EM ，Bader F ，Singhal AK ，Everitt M ，Fisher P ，Bull DA ，Selzman C ，Stehlik J ... -  《-》

Impact of Durable Ventricular Assist Device Support on Outcomes of Patients with Congenital Heart Disease Waiting for Heart Transplant.

Cedars A ，Tecson KM ，Zaidi AN ，Lorts A ，McCullough PA ... -  《-》

The change in heart allocation policy in the United States: is it working as designed?

Vega JD 《-》

Do Patients Supported With Continuous-flow Left Ventricular Assist Device Have a Sufficient Risk of Death to Justify a Priority Allocation? A Propensity Score Matched Analysis of Patients Listed in UNOS Status 2.

Mastrobuoni S ，Dell'Aquila AM ，Van Caenegem O ，Poncelet A ，Jacquet LM ，Garcia J ... -  《-》