Changes In Allocation Policy Research Articles

Abstract 4137135: Trends in Mechanical Circulatory Support After the New Heart Allocation Policy

Background: In October 2018 a new heart allocation policy (NHAP) was implemented, which resulted in patients with Intra-aortic balloon pumps (IABP) being upgraded to status-two. We sought to determine practice pattern changes in mechanical circulatory support (MCS) use as a result of the NHAP. Hypothesis: Changes in the new heart allocation policy may lead to shifts in choice of mechanical circulatory support. Methods: A retrospective analysis was conducted using the National Inpatient Sample (NIS) between 2017–2020. Hospitalizations for cardiogenic shock were identified, and stratified based on whether the patients were admitted before or after the NHAP. Baseline characteristics were compared between these cohorts, and the primary outcome of interest was the use of MCS and transplant before and after the NHAP. Subgroup analyses included patients only in transplant centers, non-transplant centers, and those who eventually underwent transplant. Results: A total of 689,935 hospitalizations were included in the final analysis, of which 279,230 (40.5%) were before the NHAP, and 410,705 (59.5%) were after. In allcomers, hospitalizations after the NHAP were less likely to undergo IABP (Adjusted odds ratio [OR] 0.81, p<0.01) and LVAD (Adjusted OR 0.73, p<0.01). These findings were consistent in most subgroup analyses. Patients who underwent transplant after the NHAP however were more than twice as likely to have received a IABP compared to those admitted prior to the NHAP (adjusted OR 2.58; p<0.01). Conclusion: IABP placement after the NHAP increased in patients who underwent transplant, as opposed to allcomers or patients who did not undergo transplant. This change in utilization of MCS may be reflective of perceived benefits and biases in regards to transplantation candidacy.

Associations Among Circle-Based Kidney Allocation, Center Waiting Time, and Likelihood of Deceased-Donor Kidney Transplantation

The kidney allocation system (KAS250), using circle-based distribution, attempts to address geographic disparities through broader sharing of deceased-donor kidney allografts. This study sought to evaluate the association between KAS250 and likelihood of deceased-donor kidney transplantation (DDKT) among waitlisted candidates, and whether the policy has differentially affected centers with shorter vs. longer waiting time. Retrospective cohort study. & Participants: 160,941 candidates waitlisted at 176 transplant centers between 3/2017-3/2024. KAS250 allocation policy. Rate of DDKT. Multivariable Cox regression, modeling KAS250 as a time-dependent variable. KAS250 was not independently associated with likelihood of DDKT overall (HR=1.01 vs. pre-KAS250, 95% C.I. 0.97-1.04). KAS250's association with likelihood of DDKT varied across centers from HR=0.18 (DDKT less likely after KAS250) to HR=17.12 (DDKT more likely) and varied even among neighboring centers. KAS250 was associated with decreased DDKT at 25.6% and increased DDKT at 18.2% of centers. Centers with previously long median waiting times (57+ months) experienced increased likelihood of DDKT after KAS250 (HR=1.20, 95% C.I. 1.15-1.26), whereas centers with previously short median waiting times (6-24mo.; HR=0.88, 0.84-0.92) experienced decreased likelihood of DDKT. Retrospective study of allocation policy changes, confounded by multiple changes over the study timeframe. Association between KAS250 and DDKT varied across centers. For one-in-four centers, DDKT was less likely after KAS250 relative to pre-KAS250 trends. Candidates at centers with previously long waiting times experienced increased likelihood of DDKT after KAS250. Thus, broader distribution of kidneys may be associated with improved equity in access to DDKT, but additional strategies may be needed to minimize disparities between centers.

Commentator Discussion: Impact of lung allocation policy change on Hispanic lung transplant outcomes: Addressing disparities and improving access

Commentator Discussion: Impact of lung allocation policy change on Hispanic lung transplant outcomes: Addressing disparities and improving access

The Year in Cardiothoracic Transplant Anesthesia: Selected Highlights From 2022 Part II: Cardiac Transplantation

These highlights focus on the research that has been published in the year 2022 and is divided into preoperative, intraoperative, and postoperative sections. The preoperative section includes research pertaining to the assessment and optimization of candidates for HTX, donor optimization and the use of extended donors, organ protection systems, and donation after circulatory death (DCD) allografts, recipient factors including cannabis use, sex, race, and comorbidities such as obesity, diabetes mellitus, and peripartum cardiomyopathy, the effects of the 2018 heart allocation policy change on waitlist and postoperative mortality, updates on HTX in patients with Covid-19, in pediatric patients, and those who require a bridge to transplant. The intraoperative section includes the use of a multidisciplinary team, a proposed transfusion algorithm, bench surgery on the allograft, and size matching. The postoperative section focuses on the research pertaining to the development and management of tricuspid regurgitation, echocardiography, arrhythmia management, and finally xenotransplantation.

Risk and Reward: Nationwide Analysis of Cardiac Transplant Center Variation in Organ Travel Distance and the Effects on Outcomes.

The 2018 UNOS allocation policy change deprioritized geographic boundaries to organ distribution, and the effects of this change have been widespread. The aim of this investigation was to analyze changes in donor transplant center distance for organ travel and corresponding outcomes before and after the allocation policy change. The UNOS database was utilized to identify all adult patients waitlisted for heart transplants from 2016 to 2021. Transplant centers were grouped by average donor heart travel distance based on whether they received more or less than 50% of organs from >250 miles away. Descriptive statistics were provided for waitlisted and transplanted patients. Regression analyses modeled waitlist mortality, incidence of transplant, overall survival, and graft survival. Centers with a longer average travel distance had a higher mean annual transplant volume with a reduction in total days on a waitlist (86.6 vs. 149.2 days), an increased cold ischemic time (3.6 vs. 3.2 h), with no significant difference in post-transplant overall survival or graft survival. The benefits of reducing waitlist time while preserving post-transplant outcomes extend broadly. The trends observed in this investigation will be useful as we revise organ transplant policy in the era of new organ procurement and preservation techniques.

Impact of lung allocation policy change on Hispanic lung transplant outcomes: Addressing disparities and improving access

ObjectiveRacial disparities in organ allocation may result in differential survival for marginalized groups. This study aims to examine the impact of the November 2017 lung allocation policy change (LAPC) on trends and outcomes of Hispanic lung transplant (LT) recipients. MethodsThe United Network for Organ Sharing database was used to identify adult (older than age 18 years) LT recipients between January 2010 and March 2023. Recipients were categorized into 3 self-identified racial groups (Hispanic, non-Hispanic White, and non-Hispanic other). The Mann-Kendall trend test was used to assess the trend in rates of Hispanic LT over 5 years pre- and 5 years post-LAPC. The primary outcome was 1-year mortality. ResultsA total of 28,495 recipients from 80 centers were included, with 15,343 (53.8%) prepolicy change and 13,152 (46.2%) postpolicy change. The racial distribution of LT recipients was pre-LAPC: Hispanic: 1013 (6.6%), White: 12,601 (82.1%), Other: 1729 (11.3%) and post-LAPC: Hispanic: 1522 (11.6%), White: 9873 (75.0%), Other: 1757 (13.4%) (P < .001). Between 2013 and 2017, the proportion of Hispanic LT recipients increased from 6.0% to 7.6% (P = .221). Post-LAPC, the proportion increased from 8.5% in 2018 to 14.4% in 2022 (P < .027). Unadjusted 1-year survival rates were pre-LAPC: Hispanic: 88.8%, White: 87.6%, Other: 86.8% (log-rank P = .260) and post-LAPC: Hispanic: 90.6%, White: 88.2%, Other: 86.1% (log-rank P < .001). ConclusionsThe LAPC has led to increased access to LT and improved 1-year survival rates among Hispanic patients. However, efforts should continue to address disparities among other racial groups and ensure equitable outcomes for all recipients of LT.

Evolving Trends and Impact of Waitlist Transfusion on Recipient Outcomes Following Heart Transplantation.

This study evaluates the clinical trends, risk factors, and impact of waitlist blood transfusion on outcomes following isolated heart transplantation. The UNOS registry was queried to identify adult recipients from January 1, 2014, to June 30, 2022. The recipients were stratified into two groups depending on whether they received a blood transfusion while on the waitlist. The incidence of waitlist transfusion was compared before and after the 2018 allocation policy change. The primary outcome was survival. Propensity score-matching was performed. Multivariable logistic regression was performed to identify predictors of waitlist transfusion. A sub-analysis was performed to evaluate the impact of waitlist time on waitlist transfusion. From the 21 926 recipients analyzed in this study, 4201 (19.2%) received waitlist transfusion. The incidence of waitlist transfusion was lower following the allocation policy change (14.3%vs. 23.7%, p < 0.001). The recipients with waitlist transfusion had significantly reduced 1-year posttransplant survival (88.8%vs. 91.9%, p < 0.001) compared to the recipients without waitlist transfusion in an unmatched comparison. However, in a propensity score-matched comparison, the two groups had similar 1-year survival (90.0%vs. 90.4%, p=0.656). Multivariable analysis identified ECMO, Impella, and pretransplant dialysis as strong predictors of waitlist transfusion. In a sub-analysis, the odds of waitlist transfusion increased nonlinearly with longer waitlist time. There is a lower incidence of waitlist transfusion among transplant recipients under the 2018 allocation system. Waitlist transfusion is not an independent predictor of adverse posttransplant outcomes but rather a marker of the patient's clinical condition. ECMO, Impella, and pretransplant dialysis are strong predictors of waitlist transfusion.

Contemporary Immunosuppression Management and 1-Year Outcomes in Dual Organ Heart Transplantation.

There have been limited reports on immunosuppression strategies and outcomes in dual organ heart transplant populations, primarily from before the 2018 United Network for Organ Sharing (UNOS) heart allocation policy change. Recent data suggested that outcomes with heart-lung and heart-liver transplants remained comparable in the new allocation era, yet heart-kidney recipients have worse 1-year survival. This single-center retrospective study evaluated adult heart-kidney, heart-liver, and heart-lung transplant recipients from September 2019 to May 2023. Immunosuppression regimen, infectious complications, and graft outcomes were collected for 12 months. A total of 36 patients (kidney n = 20, liver n = 9, and lung n = 7) were included in this study. Basiliximab was the most commonly employed induction strategy across the organ groups (12/20 in kidney, 4/9 in liver, and 7/7 in lung). All patients were on triple immunosuppression at 12 months posttransplant with prednisone wean achieved in one heart-liver recipient. Infection complications were frequently reported (95% kidney, 75% liver, 100% lung group). One patient went back to dialysis due to focal segmental glomerulosclerosis. One chronic lung allograft dysfunction was reported, but no other severe biopsy-proven rejection or retransplant was reported. The 1-year survival was 85% (17/20) in heart-kidney, 78% (7/9) in heart-liver, and 86% (6/7) in heart-lung recipients. This study summarized real-world immunosuppression strategies and outcomes in dual organ heart transplant recipients.

Waitlist Outcomes for Pediatric Heart Transplantation in the Current Era: An Analysis of the Pediatric Heart Transplant Society Database.

Waitlist mortality (WM) remains elevated in pediatric heart transplantation. Allocation policy is a potential tool to help improve WM. This study aims to identify patients at highest risk for WM to potentially inform future allocation policy changes. The Pediatric Heart Transplant Society database was queried for patients <18 years of age indicated for heart transplantation between January 1, 2010 to December 31, 2021. Waitlist mortality was defined as death while awaiting transplant or removal from the waitlist due to clinical deterioration. Because WM is low after the first year, analysis was limited to the first 12 months on the heart transplant list. Kaplan-Meier analysis and log-rank testing was conducted to compare unadjusted survival between groups. Cox proportional hazard models were created to determine risk factors for WM. Subgroup analysis was performed for status 1A patients based on body surface area (BSA) at time of listing, cardiac diagnosis, and presence of mechanical circulatory support. In total 5974 children met study criteria of which 3928 were status 1A, 1012 were status 1B, 963 were listed status 2, and 65 were listed status 7. Because of the significant burden of WM experienced by 1A patients, further analysis was performed in only patients indicated as 1A. Within that group of patients, those with smaller size and lower eGFR had higher WM, whereas those patients without congenital heart disease or support from a ventricular assist device (VAD) at time of listing had decreased WM. In the smallest size cohort, cardiac diagnoses other than dilated cardiomyopathy were risk factors for WM. Previous cardiac surgery was a risk factor in the 0.3 to 0.7 m2 and >0.7 m2 BSA groups. VAD support was associated with lower WM other than in the single ventricle cohort, where VAD was associated with higher WM. Extracorporeal membrane oxygenation and mechanical ventilation were associated with increased risk of WM in all cohorts. There is significant variability in WM among status-1A patients. Potential refinements to current allocation system should factor in the increased WM risk we identified in patients supported by extracorporeal membrane oxygenation or mechanical ventilation, single ventricle congenital heart disease on VAD support and small children with congenital heart disease, restrictive cardiomyopathy, or hypertrophic cardiomyopathy.

Effects of the March 2021 Allocation Policy Change on Key Deceased-donor Kidney Transplant Metrics.

A major change to deceased-donor kidney allocation in the United States, Kidney Allocation System 250 (KAS250), was implemented on March 15, 2021. Evaluating the consequences of this policy on critical system performance metrics is critical to determining its success. We performed a retrospective analysis of critical performance measures of the kidney transplant system by reviewing all organs procured during a 4-y period in the United States. To mitigate against possible effects of the COVID-19 pandemic, Scientific Registry of Transplant Recipients records were stratified into 2 pre- and 2 post-KAS250 eras: (1) 2019; (2) January 1, 2020-March14, 2021; (3) March 15, 2021-December 31, 2021; and (4) 2022. Between-era differences in rates of key metrics were analyzed using chi-square tests with pairwise z-tests. Multivariable logistic regression and analysis of variations methods were used to evaluate the effects of the policy on rural and urban centers. Over the period examined, among kidneys recovered for transplant, nonuse increased from 19.7% to 26.4% (all between-era P < 0.05) and among all Kidney Donor Profile Index strata. Cold ischemia times increased (P < 0.001); however, the distance between donor and recipient hospitals decreased (P < 0.05). Kidneys from small-metropolitan or nonmetropolitan hospitals were more likely to not be used over all times (P < 0.05). Implementation of KAS250 was associated with increased nonuse rates across all Kidney Donor Profile Index strata, increased cold ischemic times, and shorter distance traveled.

Liver Transplant Costs and Activity After United Network for Organ Sharing Allocation Policy Changes

A new liver allocation policy was implemented by United Network for Organ Sharing (UNOS) in February 2020 with the stated intent of improving access to liver transplant (LT). There are growing concerns nationally regarding the implications this new system may have on LT costs, as well as access to a chance for LT, which have not been captured at a multicenter level. To characterize LT volume and cost changes across the US and within specific center groups and demographics after the policy implementation. This cross-sectional study collected and reviewed LT volume from multiple centers across the US and cost data with attention to 8 specific center demographics. Two separate 12-month eras were compared, before and after the new UNOS allocation policy: March 4, 2019, to March 4, 2020, and March 5, 2020, to March 5, 2021. Data analysis was performed from May to December 2022. Center volume, changes in cost. A total of 22 of 68 centers responded comparing 1948 LTs before the policy change and 1837 LTs postpolicy, resulting in a 6% volume decrease. Transplants using local donations after brain death decreased 54% (P < .001) while imported donations after brain death increased 133% (P = .003). Imported fly-outs and dry runs increased 163% (median, 19; range, 1-75, vs 50, range, 2-91; P = .009) and 33% (median, 3; range, 0-16, vs 7, range, 0-24; P = .02). Overall hospital costs increased 10.9% to a total of $46 360 176 (P = .94) for participating centers. There was a 77% fly-out cost increase postpolicy ($10 600 234; P = .03). On subanalysis, centers with decreased LT volume postpolicy observed higher overall hospital costs ($41 720 365; P = .048), and specifically, a 122% cost increase for liver imports ($6 508 480; P = .002). Transplant centers from low-income states showed a significant increase in hospital (12%) and import (94%) costs. Centers serving populations with larger proportions of racial and ethnic minority candidates and specifically Black candidates significantly increased costs by more than 90% for imported livers, fly-outs, and dry runs despite lower LT volume. Similarly, costs increased significantly (>100%) for fly-outs and dry runs in centers from worse-performing health systems. Based on this large multicenter effort and contrary to current assumptions, the new liver distribution system appears to place a disproportionate burden on populations of the current LT community who already experience disparities in health care. The continuous allocation policies being promoted by UNOS could make the situation even worse.

#2425 A change in deceased donor allocation policy may provide gender equality in kidney transplantation

Abstract Background and Aims Overcoming gender disparity in access to kidney transplantation is a well-established universal challenge. The SRTR data showed a greater proportion of males than females for kidney transplant waitlists (61% vs 39%). Similarly, of 831 deceased donor kidney transplants (DDKT) conducted between 1997 and 2018 at IKDRC-ITS, 68% have been male and 32% female recipients while majority of donors in living donor kidney transplants (LDKT) were females. Prior to 2020, there duration on transplantation waitlist was the only criteria for deceased donor kidney allocation. In January 2020, SOTTO Gujarat was formed which implements a point system based deceased donor allocation policy including HLA mismatch, Panel Reactive Antibody, Donor Specific Antibody, age and duration on dialysis, amongst others. 2 additional points are allocated to female recipients in this allocation system. The aim is to study the impact of change in DDKT allocation policy on gender disparity. Method This is a retrospective, single-center, observational study. Number of male and female kidney transplant recipients was collected from the medical records held by the department of nephrology between January 2014 to December 2023. The data was categorized as before and after implementation of SOTTO Gujarat guidelines and analyzed. Results A total of 3182 kidney transplants were conducted at our centre over the study period, 2231 were LDKT while only 951 were DDKT. We found the percentage of female LDKT recipients to have remained disproportionately low as compared to male DDKT throughout the study period, while there was a gradually progressive increase in the percentage of female DDKT recipients with almost a doubling of female DDKT recipients from 27.57% in 2019 to 54.19% in 2023. This may be attributed to the compounding effect of allocating points to DSA, PRA, age of patient and gender as female patients tend to have higher PRA and DSA level after sensitization. Conclusion This study provides new insights into steps that can be taken to bridge the gender gap in DDKT. It shows that implementing a point based system for DDKT allocation policy with extra points for female recipients may increase the number of kidney transplants in them. Similar policy may be undertaken by other transplant centers as a bridge to achieve temporary solution till underlying factors leading to gender disparity are better understood and ways to overcome them are formed. Action should be taken to provide for equitable access to females at all stages, from diagnosis to treatment such as intensive and timely counselling. Policies for social empowerment of women must be formed including literacy, better maternal and child healthcare and financial independence. Raising awareness and education at a grassroot level must remain the key component to change public attitude regarding organ donation and ensure equitable access to transplantation for all.

Changes in Donor Utilization and Outcomes for Patients Bridged With Durable Left Ventricular Assist Device.

We studied the impact of the 2018 heart allocation policy change on donor characteristics and posttransplant outcomes of left ventricular assist device (LVAD)-bridged heart transplant (HT) recipients. Left ventricular assist device-bridged adult HT recipients from October 2014 to October 2022 in the United Network for Organ Sharing database were categorized into old allocation policy (OAP) and new allocation policy (NAP) cohorts. Baseline characteristics, posttransplant outcomes, and subgroup analyses of unstable and stable LVAD-bridged recipients were assessed. The study included 7,384 HT recipients; 4,345 (58.8%) were transplanted in the OAP era and 3,039 (41.2%) in the NAP era. Old allocation policy recipients were most frequently status 1A at transplantation (71.1%), whereas NAP recipients were most frequently status 3 (40.0%), and status 4 (31.9%). Median donor sequence number (DSN) was higher in the NAP versus OAP era (9 vs. 3, p < 0.001). On multivariable analysis, NAP recipients had 20% higher 1 year mortality compared to OAP (adjusted hazard ratio [aHR] = 1.20 [95% confidence interval {CI}: 1.04-1.40], p = 0.01). Status 1 or 2 recipients had 28% higher 1 year mortality compared to status 1A (aHR = 1.28 [95% CI: 1.01-1.63], p = 0.04). Status 1 and 2 LVAD-supported recipients had higher mortality following the 2018 allocation change, indicating the need for closer surveillance of LVAD-bridged patients who may decompensate on the waitlist.

Bridge-to-transplant temporary mechanical circulatory support and risk of allosensitization.

Since the 2018 change in the US adult heart allocation policy, more patients are bridged-to-transplant on temporary mechanical circulatory support (tMCS). Previous studies indicate that durable left ventricular assist devices (LVAD) may lead to allosensitization. The goal of this study was to assess whether tMCS implantation is associated with changes in sensitization. We included patients evaluated for heart transplants between 2015 and 2022 who had alloantibody measured before and after MCS implantation. Allosensitization was defined as development of new alloantibodies after tMCS implant. A total of 41 patients received tMCS before transplant. Nine (22.0%) patients developed alloantibodies following tMCS implantation: 3 (12.0%) in the intra-aortic balloon pump group (n=25), 2 (28.6%) in the microaxial percutaneous LVAD group (n=7), and 4 (44.4%) in the veno-arterial extra-corporeal membrane oxygenation group (n=9)-p=.039. Sensitized patients were younger (44.7±11.6 years vs. 54.3±12.5 years, p=.044), were more likely to be sensitized at baseline - 3 of 9 (33.3%) compared to 2 out of 32 (6.3%) (p=.028) and received more transfusions with red blood cells (6 (66.6%) vs. 8 (25%), p=.02) and platelets (6 (66.6%) vs. 5 (15.6%), p=.002). There was no significant difference in tMCS median duration of support (4 [3,15] days vs. 8.5 [5,14.5] days, p=.57). Importantly, out of the 11 patients who received a durable LVAD after tMCS, 5 (45.5%) became sensitized, compared to 4 out of 30 patients (13.3%) who only had tMCS-p=.028. Our findings suggest that patients bridged-to-transplant with tMCS, without significant blood product transfusions and a subsequent durable LVAD implant, have a low risk of allosensitization. Further studies are needed to confirm our findings and determine whether risk of sensitization varies by type of tMCS and duration of support.

The impact of an academic counselling learning analytics tool: Evidence from 3 years of use

AbstractDespite the importance of academic counselling for student success, providing timely and personalized guidance can be challenging for higher education institutions. In this study, we investigate the impact of counselling instances supported by a learning analytics (LA) tool, called TrAC, which provides specific data about the curriculum and grades of each student. To evaluate the tool, we measured changes in students' performance ranking position over 3 years and compared the performance of students who received counselling with and without the tool. Our results show that using the tool is related to an improvement in cohort ranking. We further investigated the characteristics of counselled students using cluster analyses. The findings highlight the potential beneficial influence on academic outcomes arising from the provision of guidance to students regarding their course load decisions via TrAC‐mediated counselling. This study contributes to the field of LA by providing evidence of the impact of counselling supported by an LA tool in a real‐world setting over a long period of time. Our results suggest that incorporating LA into academic counselling practices can improve student success. Practitioner notesWhat is already known about this topic By analysing student performance, teaching strategies and resource impact, learning analytics (LA) empowers institutions to make informed changes in curriculum design, resource allocation and educational policies. Through insights into academic progress, engagement and behaviour, LA counselling tools enable the identification of at‐risk students and those needing additional support. In the related literature, there are areas for further exploration such as understanding the scalability and long‐term effects of interventions on student success and retention. What this paper adds Through rigorous data analysis, the paper establishes a connection between LA utilization and enhanced student performance, offering concrete evidence of the effectiveness of LA interventions. By examining various factors such as academic stage and course load, the research offers valuable insights into the contextual nuances that optimize the outcomes of LA tool‐based support. It adds to the growing body of evidence that supports the efficacy of data‐driven interventions in education, fostering a more informed and evidence‐based approach to student support and success. Implications for practice and policy Enhanced student support strategies: By tailoring counselling interventions to align with the identified effective conditions, educators can proactively address individual student needs, improving academic outcomes and retention rates. Informed decision making: The demonstrated positive impact highlights the potential of similar data‐driven initiatives to foster student success. Policymakers can consider incentivizing the adoption of such interventions at institutional levels. Future directions for research: By identifying contextual factors that influence the efficacy of LA interventions, it encourages further exploration into how other LA interventions can be optimized for specific conditions. This can guide the development of more precise and effective student support strategies in the future.

(451) - Allocation Policy Change is Associated with Higher Rates of Myocardial Recovery in Ambulatory, Non-MCS Heart Transplant Candidates

(451) - Allocation Policy Change is Associated with Higher Rates of Myocardial Recovery in Ambulatory, Non-MCS Heart Transplant Candidates

(437) - Have Heart Transplant Allocation Policy Changes Brought Improvements in Mortality for Children and Adults with Cardiomyopathy? A UNOS Database Analysis

(437) - Have Heart Transplant Allocation Policy Changes Brought Improvements in Mortality for Children and Adults with Cardiomyopathy? A UNOS Database Analysis

(324) - Association of Center Volume with Post-Transplant Survival After the 2018 US Heart Allocation Policy Change

(324) - Association of Center Volume with Post-Transplant Survival After the 2018 US Heart Allocation Policy Change

(546) - Association of the 2018 US Heart Allocation Policy Change and the Survival Benefit of Heart Transplantation

(546) - Association of the 2018 US Heart Allocation Policy Change and the Survival Benefit of Heart Transplantation

(463) - Heart Transplantation in Young Adults: Comparison of Demographics and Outcomes at Pediatric and Adult Centers Following The 2018 Heart Allocation Policy Change

(463) - Heart Transplantation in Young Adults: Comparison of Demographics and Outcomes at Pediatric and Adult Centers Following The 2018 Heart Allocation Policy Change