Heart failure & cardiomyopathies
Sex Differences in Heart Transplantation Outcomes: A 5-Year Review of the 2018 U.S. Allocation Policy
Main finding · Rate of HT (waitlist cohort)Result — go to the resultAdjusted subdistribution hazard ratio 1.24 95% CI 1.18–1.31Authors' conclusion
Five years after implementation of the 2018 allocation policy, women have higher rates of HT and lower delisting due to death or clinical deterioration as compared to men with lower long-term post-HT survival.
Study context
- Population
- Adults (≥18 years) listed for first-time, single-organ heart transplant (HT) in the United Network for Organ Sharing Registry, and first-time single-organ HT recipients, after the 2018 U.S. allocation policy revisionwaitlist candidates (26.3% women) 15,422 · HT recipients (27.4% women) 12,892
- Exposure
- Women vs men
Methodological detailswaitlist cohort, transplant cohort, October 18, 2018, and October 17, 2023
- Waitlist cohort
- Transplant cohort
- October 18, 2018, and October 17, 2023
Main finding
Rate of HT (waitlist cohort)
Adjusted subdistribution hazard ratio
1.24
95% CI 1.18–1.31
P < 0.001
Women vs men
aSHR 1.24 (95% CI 1.18–1.31); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Delisting for death or clinical deterioration (waitlist cohort) · lower rate in women | aSHR 0.81 (95% CI 0.70–0.94) | P = 0.005 | |
| Adjusted post-HT mortality · 1-year · higher in women | aHR 1.14 (95% CI 1.02–1.28) | P = 0.019 | |
| Adjusted post-HT mortality · 5-years · higher in women | aHR 1.14 (95% CI 1.02–1.27) | P = 0.021 | |
| 0.512Ratio (log scale) |
Original publication
Sex Differences in Heart Transplantation Outcomes: A 5-Year Review of the 2018 U.S. Allocation Policy. JACC Adv. Published 20 May 2026. doi:10.
Summarised from the published abstract; every number is checked against it