Affordable Access

deepdyve-link
Publisher Website

Influence of new Eurotransplant heart allocation policy on outcome of heart transplant candidates in Germany.

Authors
  • Komoda, Takeshi1
  • Hetzer, Roland
  • Lehmkuhl, Hans B
  • 1 Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany. [email protected] , (Germany)
Type
Published Article
Journal
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
Publication Date
Oct 01, 2008
Volume
27
Issue
10
Pages
1108–1114
Identifiers
DOI: 10.1016/j.healun.2008.07.011
PMID: 18926402
Source
Medline
Language
English
License
Unknown

Abstract

The Eurotransplant community adopted an urgency-based heart allocation algorithm in August 2000. The effect of the new allocation policy on critically ill patients with end-stage heart failure was studied. During 1997-1999 (old algorithm) and 2001-2006 (new algorithm), 661 heart transplant candidates received heart transplantation (HTx) or a ventricular assist device (VAD) at our center. Those patients who received VAD or urgent HTx (decompensated) were assigned to Group D-97 (n = 108) and Group D-01 (n = 307) under the old and new algorithm, respectively, and regarded as critically ill. We defined subgroups of critically ill patients as follows: Group VAD-97 (n = 92) and Group VAD-01 (n = 184), who underwent primary VAD implantation under the old and new allocation algorithm, respectively; and Group UTx-97 (n = 16) and Group UTx-01 (n = 123), who underwent urgent HTx under the old and new algorithm. Group survival rates were studied. Group D-01 had significantly higher survival rates than D-97 (61.7% vs 44.4%, 2-year survival; p < 0.001). The ratio of patients with urgent HTx (Group UTx-01) among the patients in Group D-01 was significantly greater than that in Group D-97 (40.1% vs 14.8%, p < 0.001). Survival rates of Group UTx-01 after urgency listing (71.5% for 2-year survival) were significantly better than those after VAD implantation in Groups VAD-01 and VAD-97. The new heart allocation algorithm has successfully improved survival rates of critically ill patients, enabling these patients to receive urgent HTx.

Report this publication

Statistics

Seen <100 times