Increase in and Donor Organ Ischemic Time and Travel Distance after the Implementation of the New Heart Allocation System

Purpose In October of 2018, OPTN revised the heart allocation policy, allowing for offers from a wider geographic area for patients of higher acuity. This study aims to examine its effect on donor organ travel distance and ischemic time, which may adversely affect outcomes. Methods We performed a retrospective analysis of adult patients who received heart transplants in the OPTN database between May, 2018- May, 2019. Two cohorts were defined with respect to the policy's timeline: patients transplanted before (Era 1) or after 10/2018 (Era 2). Results We identified 2,434 patients 1,294 of whom were transplanted in era 1 and 1,140 in era 2. Age, gender, etiology, and comorbidities were similar. In era 2, IABP (7.7% vs. 22.5%, p 4 hours nearly doubled (15% vs 29%, p Conclusion Patients receiving heart transplants, especially those of higher acuity, experience longer ischemic windows and travel distances in Era 2. Future studies on the impact this trend on transplant outcomes is warranted.