Inclusive Approaches to Heart Transplants Seek Success

Expansion of heart transplant procedures accepted hearts from older donors with additional medical conditions and also transplant recipients suffering with severe illnesses at Yale New Haven Hospital.

Doctors at Yale New Haven Hospital used a more aggressive selection process to a number of heart transplants performed while maintaining positive patient outcomes, according to a new study.

The study focused at short-term patient outcomes //for two groups, 49 patients who received heart transplants from 2014 to 2018 and 58 patients who had their heart transplants in the year after the hospital adopted a more aggressive selection process for donor recipients (2018-2019).

‘Inclusive and multidisciplinary approaches to selecting donor hearts and transplant recipients enable the hospitals to successfully treat more patients in need of transplants.’

The selection process significantly shortened the waiting period for heart patients, from 242 days to 41 days. However, patients' survival rate at 180 days after the transplant remained nearly unchanged.

The expansion of heart transplant procedures at Yale New Haven Hospital meant accepting hearts from older donors with associated medical conditions, as well as accepting transplant recipients with more severe illnesses.

The expansion of heart transplant procedures at the hospital, coincided with the implementation of the new United Network for Organ Sharing (UNOS) donor heart allocation system in the United States.

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"I think this is the takeaway for other centers -- that such a change in the approach could create opportunities for patients in need while maintaining outcomes in the short term," said Makoto Mori, M.D., a surgical resident at Yale and first author of the study.

Yale's increase in heart transplant cases was significantly larger than the volume change seen at other heart transplant centers in the same region during that period, including Hartford Hospital, Tufts Medical Center, Brigham and Women's Hospital, and Massachusetts General Hospital.

"We used a multidisciplinary approach and 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," said co-author Arnar Geirsson, M.D., chief of cardiac surgery at Yale New Haven Hospital.

Source-Medindia