{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T06:52:32Z","timestamp":1775199152370,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T00:00:00Z","timestamp":1638057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Intra\u2010aortic balloon pump (IABP) support may improve the hemodynamic profiles of patients in cardiogenic shock and bridge patients to heart transplant. In 2018, the United Network for Organ Sharing (UNOS) introduced new heart allocation criteria that increased the waitlist status of patients with IABPs to Status 2. This study assesses the impact of this change on IABP use and outcomes of patients with IABPs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We queried the UNOS database for first adult heart transplant candidates with IABPs listed or transplanted before and after the UNOS policy changes (October 18, 2016\u2013October 17, 2018, or October 18, 2018\u2013September 4, 2020). We compared post\u2010transplant survival and waitlist outcomes using Kaplan\u2010Meier and Fine\u2010Gray analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two thousand three hundred fifty\u2010eight patients met inclusion criteria. Utilization of IABPs for hemodynamic support increased by 338% in the two years after the policy change. Patients with IABPs listed after the policy change were more likely to receive a transplant and were transplanted more quickly (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Posttransplant survival was comparable before and after the policy change (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.056), but non\u2010transplanted patients were more likely to be delisted post\u2010policy change (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The UNOS allocation criteria have benefited patients bridged with an IABP, given the higher transplant rate and shorter time to transplant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14533","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T05:21:13Z","timestamp":1637126473000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Impact of UNOS allocation policy changes on utilization and outcomes of patients bridged to heart transplant with intra\u2010aortic balloon pump"],"prefix":"10.1111","volume":"36","author":[{"given":"Gillian","family":"O'Connell","sequence":"first","affiliation":[{"name":"Department of Surgery Division of Cardiothoracic and Vascular Surgery Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5970-0517","authenticated-orcid":false,"given":"Amy S.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Cardiothoracic and Vascular Surgery Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Kurlansky","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Cardiothoracic and Vascular Surgery Columbia University Medical Center  New York New York USA"},{"name":"Center of Innovation and Outcomes Research Department of Surgery Columbia University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuming","family":"Ning","sequence":"additional","affiliation":[{"name":"Center of Innovation and Outcomes Research Department of Surgery Columbia University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryjane A.","family":"Farr","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Sayer","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nir","family":"Uriel","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshifumi","family":"Naka","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Cardiothoracic and Vascular Surgery Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Cardiothoracic and Vascular Surgery Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,11,28]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"UNOS Policy Notice Proposal to Modify the Adult Heart Allocation System.2018.1\u201038. Available at:https:\/\/optn.transplant.hrsa.gov\/media\/2028\/thoracic_policynotice_201612.pdf. Accessed November 22 2020."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2018.04.008"},{"key":"e_1_2_11_4_1","first-page":"206","article-title":"Intra\u2010Aortic Balloon Pump Bridging to Heart Transplantation: impact of the 2018 Allocation Change","author":"Huckaby LaurenV","year":"2020","journal-title":"Circ Heart Fail"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.0692"},{"key":"e_1_2_11_6_1","volume-title":"R: A language and environment for statistical computing. R Foundation for Statistical Computing","author":"R Core Team","year":"2020"},{"key":"e_1_2_11_7_1","unstructured":"MayerM (2020). R package \u2018missRanger\u2019.https:\/\/cran.r\u2010project.org\/web\/packages\/missRanger\/index.html"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2019.07.461"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1900486"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.05.010"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.10.152"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.11.002"},{"key":"e_1_2_11_13_1","article-title":"Extracorporeal membrane oxygenation bridge to heart transplant: trends following the allocation change","author":"Hess NR","year":"2020","journal-title":"J Card Surg"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001128"},{"key":"e_1_2_11_15_1","unstructured":"Organ Procurement and Transplantation Network Policy Notice: Eliminate the Use of DSAs in Thoracic Distribution.2019.https:\/\/optn.transplant.hrsa.gov\/media\/3003\/thoracic_policynotice_201906.pdf"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2020.03.010"},{"key":"e_1_2_11_17_1","article-title":"Impact of the United Network for Organ Sharing 2018 Donor Heart Allocation System on Transplant Morbidity and Mortality","author":"Stern LK","year":"2020","journal-title":"Clin Transplant"},{"key":"e_1_2_11_18_1","first-page":"1","article-title":"Evolving Trends in Adult Heart Transplant with the 2018 Heart Allocation Policy Change","volume":"15213","author":"Kilic A","year":"2020","journal-title":"JAMA Cardiology"},{"key":"e_1_2_11_19_1","article-title":"Outcomes of ambulatory axillary intra\u2010 aortic balloon pump as a bridge to heart transplantation","author":"Nishida H","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2020.01.011"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14533","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.14533","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14533","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T09:32:15Z","timestamp":1693215135000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.14533"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,28]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1111\/ctr.14533"],"URL":"https:\/\/doi.org\/10.1111\/ctr.14533","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,28]]},"assertion":[{"value":"2021-09-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14533"}}