Heart Retransplantation Outcomes before and after the UNOS Donor Heart Allocation Policy Change

Purpose To compare heart retransplantation (reHTx) mortality six months before and after the United Network of Organ Sharing (UNOS) donor heart allocation policy change to determine if the new allocation process may correlate to a difference in mortality. Methods Using the UNOS Organ Registry we compared mortality rates for patients undergoing reHTx 6 months before and after the initiation of the UNOS allocation policy change with a multivariate Cox proportional hazard regression model adjusting for age, sex, race, diabetes diagnosis, ischemic time, need for dialysis/life support, recipient wait-time, and HLA mismatch. We excluded patients who were age Results There were a total of 31 patients who underwent reHTx 6-months prior to the UNOS allocation system change and 24 patients 6 months after the change. The total days on the waiting list was significantly longer prior to the UNOS allocation change at 52.0 vs 12.5 days after the change (p=0.005). There was no statistically significant difference in mortality rates between recipients 6 months pre- and post-UNOS allocation policy change, 11.5% vs 30.5% (p=0.2960) respectively. Conclusion Under the new UNOS donor heart allocation policy, patients requiring reHTx have shorter wait list times and no significant difference in mortality compared to the previous allocation system.