Steve September 18, 2020

Sept. 18 (UPI) — Accepting hearts from older donors and those with some chronic health conditions allowed surgeons at Yale New Haven Hospital to perform more transplants and reduce the time recipients spent on the waiting list, without negatively impacting safety and health, an analysis published Friday by JAMA Network Open found.

With the changes, the hospital was able to more than quadruple the number of heart transplants it performed and cut the average time recipients were on the waiting list by nearly 200 days, the researchers said.

The findings suggest that a more “inclusive” approach to selecting donor hearts and transplant recipients can enable hospitals to successfully treat more patients who need transplants, they said.

“We … made strategic changes in donor and recipient selection, which allowed us to increase the number of heart transplants performed and therefore help more patients with advanced heart failure in a safe and an effective manner,” study co-author Dr. Arnar Geirsson, chief of cardiac surgery at Yale New Haven Hospital, said in a statement.

More than 2,000 Americans undergo heart transplant procedures annually, according to the United Network for Organ Sharing. As many as 4,000 people are on waiting lists for a donor heart, the organ-sharing organization Donate Life estimates.

To meet demand, many transplant centers have expanded eligibility for heart donors to include those with hepatitis C and HIV. Hepatitis C can be successfully treated in recipients using antiviral medications, and some HIV patients now receive approval for transplants because of advancements in treating that virus.

The expansion of heart transplant procedures at Yale New Haven, implemented in September 2018, coincided with the changes to the the United Network for Organ Sharing heart allocation system. The changes increased the average age of donors and the average distance the organ traveled from donor to recipient.

For the JAMA Network Open study, researchers looked at short-term patient outcomes for two groups: 49 patients who underwent heart transplants between 2014 and 2018, and 58 patients who had their transplants in 2018-19, the year after the hospital adopted its new approach.

The “more aggressive” donor selection process significantly shortened the waiting period for heart patients to 41 days from 242 days, while patients’ survival rate at 180 days after transplant remained essentially unchanged, the researchers said.

“Such a change in the approach could create opportunities for patients in need while maintaining outcomes in the short term,” study co-author Dr. Makoto Mori, a surgical resident at Yale, said in a statement.

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