Heart failure & cardiomyopathiesResearch article
Potential Impact of the Organ Procurement and Transplantation Network (OPTN) Status Escalation Policy for Adult Heart Transplant Candidates With Durable Left Ventricular Assist Devices (LVADs)
- Using OPTN data, we identified all adult heart transplant candidates with a durable LVAD
- competing events analysis
Authors' conclusion
Almost all listed candidates with durable LVADs either experience a complication, status upgrade or are removed from the waitlist within 6 years of obtaining a durable LVAD. The upcoming OPTN policy is unlikely to prevent device complications before granting status upgrades and will likely impact a small percentage of candidates with durable LVADs.
Study context
- Population
- Adult heart transplant candidates with a durable LVAD implanted between October 18, 2018 and May 31, 2025adult patients listed for heart transplant who received a durable LVAD
- Participants
- 4,967 candidates
Main finding
As reported in the abstract
Justifications submitted
2879
Patients with justifications
1812 (36.5%)
Further findings
Cumulative incidence of complications and status upgrades · 6 years after durable LVAD implantation
- Complications and status upgrades
- 42.1% (95% CI, 40.5%-43.8%)
- Transplantation
- 36.0% (95% CI, 34.6%-37.6%)
- transplantation and waitlist removal before complications treated as competing events
Remaining on the waitlist · 6 years after durable LVAD implantation
- Of the 3779 patients not censored administratively, remained on the waitlist
- 47 (1.2%)
Waitlist status change had the policy been implemented on June 1, 2025
- Share of waitlist changing statuses instantaneously
- 4.7%
Original publication
Summarised from the published abstract; every number is checked against it