Changes in Wait List Mortality, Transplantation Rates and Early Post-Transplant Outcomes in LVAD BTT with New Heart Transplant Allocation Score. A UNOS Database Analysis

Purpose To evaluate the effect of the new heart transplant allocation system on LVAD supported patients listed as bridge to transplantation (BTT). Methods Adult patients, who were listed for heart transplant between October 1,2016 and September 30, 2019, and were supported with an LVAD, enrolled in the UNOS database were enrolled in this study. Patients were classified according in the old or new system if they were listed or transplanted before or after October 18, 2018. Results A total of 2184 LVAD patients were listed for transplant. Of these, 1229 were classified in the old and 955 in the new system. The cumulative incidence of death or removal from the transplant list due to worsening clinical status, 1 year after listing, was lower in the new system (5% vs. 9%, p Conclusion With the implementation of the new HT allocation system, LVAD-BTT patients have a lower frequency of transplantation and similar short-term post-transplant survival. LVAD-BTT patients are more likely to receive Hep C (+) donor hearts.