{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T23:40:56Z","timestamp":1769125256701,"version":"3.49.0"},"reference-count":16,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Patients with restrictive or hypertrophic cardiomyopathy (RCM\/HCM) and congenital heart disease (CHD) do not derive clinical benefit from inotropes and mechanical circulatory support. Concerns were expressed that the new heart allocation system implemented in October 2018 would disadvantage these patients. This paper aimed to examine the impact of the new adult heart allocation system on transplantation and outcomes among patients with RCM\/HCM\/CHD.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We identified adult patients with RCM\/HCM\/CHD in the United Network for Organ Sharing (UNOS) database who were listed for or received a cardiac transplant from April 2017-June 2020. The cohort was separated into those listed before and after allocation system changes. Demographics and recipient characteristics, donor characteristics, waitlist survival, and post-transplantation outcomes were analyzed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The number of patients listed for RCM\/HCM\/CHD increased after the allocation system change from 429 to 517. Prior to the change, the majority RCM\/HCM\/CHD patients were Status 1A at time of transplantation; afterwards, most were Status 2. Wait times decreased significantly for all: RCM (41 days vs 27 days; P&lt;0.05), HCM (55 days vs 38 days; P&lt;0.05), CHD (81 days vs 49 days; P&lt;0.05). Distance traveled increased for all: RCM (76 mi. vs 261 mi, P&lt;0.001), HCM (88 mi. vs 231 mi. P&lt;0.001), CHD (114 mi vs 199 mi, P&lt;0.05). Rates of transplantation were higher for RCM and CHD (P&lt;0.01), whereas post-transplant survival remained unchanged.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The new allocation system has had a positive impact on time to transplantation of patients with RCM, HCM, and CHD without negatively influencing survival.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0247789","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T18:46:17Z","timestamp":1614710777000},"page":"e0247789","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Impact of the new heart allocation policy on patients with restrictive, hypertrophic, or congenital cardiomyopathies"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8715-6718","authenticated-orcid":true,"given":"Fouad","family":"Chouairi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2774-251X","authenticated-orcid":true,"given":"Clancy W.","family":"Mullan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sounok","family":"Sen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Mori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9166-4838","authenticated-orcid":true,"given":"Michael","family":"Fuery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W.","family":"Elder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Lesse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelsey","family":"Norton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine A.","family":"Clark","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. Elliott","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Mulligan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Formica","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph G.","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Jacoby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Maulion","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Anwer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnar","family":"Geirsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nihar R.","family":"Desai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tariq","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"issue":"6","key":"pone.0247789.ref001","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1161\/CIRCHEARTFAILURE.114.001435","article-title":"Advanced heart failure with preserved systolic function in nonobstructive hypertrophic cardiomyopathy: under-recognized subset of candidates for heart transplant","volume":"7","author":"EJ Rowin","year":"2014","journal-title":"Circ Heart Fail"},{"issue":"12","key":"pone.0247789.ref002","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1016\/j.healun.2012.09.018","article-title":"Outcomes of adults with restrictive cardiomyopathy after heart transplantation","volume":"31","author":"EC DePasquale","year":"2012","journal-title":"J Heart Lung Transplant"},{"issue":"9","key":"pone.0247789.ref003","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/j.healun.2014.05.001","article-title":"Adults with congenital heart disease and heart transplantation: optimizing outcomes","volume":"33","author":"SW Goldberg","year":"2014","journal-title":"J Heart Lung Transplant"},{"issue":"8","key":"pone.0247789.ref004","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/j.amjcard.2017.12.044","article-title":"Impact of Advanced Therapies for Improving Survival to Heart Transplant in Patients with Hypertrophic Cardiomyopathy","volume":"121","author":"EJ Rowin","year":"2018","journal-title":"Am J Cardiol"},{"issue":"3","key":"pone.0247789.ref005","doi-asserted-by":"crossref","first-page":"e004665","DOI":"10.1161\/CIRCHEARTFAILURE.117.004665","article-title":"Mechanical Circulatory Support Device Utilization and Heart Transplant Waitlist Outcomes in Patients With Restrictive and Hypertrophic Cardiomyopathy","volume":"11","author":"L Sridharan","year":"2018","journal-title":"Circ Heart Fail"},{"key":"pone.0247789.ref006","article-title":"A change of heart: Preliminary results of the US 2018 adult heart allocation revision","author":"RR Goff","year":"2020","journal-title":"Am J Transplant"},{"key":"pone.0247789.ref007","unstructured":"Callahan LR. Proposal to Modify the Adult Heart Allocation System (https:\/\/optn.transplant.hrsa.gov\/media\/1244\/08_adult_heart_allocation_part1.pdf). Date Accessed: Aug 28 2020. [cited 2020 August 28]. Available from: https:\/\/optn.transplant.hrsa.gov\/media\/1244\/08_adult_heart_allocation_part1.pdf."},{"issue":"3","key":"pone.0247789.ref008","doi-asserted-by":"crossref","first-page":"e004378","DOI":"10.1161\/CIRCHEARTFAILURE.117.004378","article-title":"Outcomes in Patients With Hypertrophic Cardiomyopathy Awaiting Heart Transplantation","volume":"11","author":"J Zuniga Cisneros","year":"2018","journal-title":"Circ Heart Fail"},{"issue":"9","key":"pone.0247789.ref009","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.jchf.2016.03.010","article-title":"Does Survival on the Heart Transplant Waiting List Depend on the Underlying Heart Disease?","volume":"4","author":"EM Hsich","year":"2016","journal-title":"JACC Heart Fail"},{"key":"pone.0247789.ref010","unstructured":"Network OPaT. Review Board Guidance for Hypertrophic\/Restrictive (HCM\/RCM) Cardiomyopathy Exception Requests."},{"issue":"2","key":"pone.0247789.ref011","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.jtcvs.2006.09.019","article-title":"The effect of ischemic time on survival after heart transplantation varies by donor age: an analysis of the United Network for Organ Sharing database","volume":"133","author":"MJ Russo","year":"2007","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"6","key":"pone.0247789.ref012","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1111\/ajt.15760","article-title":"Great variability in donor heart acceptance practices across the United States","volume":"20","author":"KK Khush","year":"2020","journal-title":"Am J Transplant."},{"issue":"8","key":"pone.0247789.ref013","doi-asserted-by":"crossref","first-page":"e006971","DOI":"10.1161\/CIRCHEARTFAILURE.120.006971","article-title":"Intra-Aortic Balloon Pump Bridging to Heart Transplantation: Impact of the 2018 Allocation Change","volume":"13","author":"LV Huckaby","year":"2020","journal-title":"Circ Heart Fail"},{"issue":"17","key":"pone.0247789.ref014","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1056\/NEJMoa1812406","article-title":"Heart and Lung Transplants from HCV-Infected Donors to Uninfected Recipients","volume":"380","author":"AE Woolley","year":"2019","journal-title":"N Engl J Med"},{"issue":"6","key":"pone.0247789.ref015","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1001\/jamacardio.2020.0692","article-title":"Use of Temporary Mechanical Circulatory Support for Management of Cardiogenic Shock Before and After the United Network for Organ Sharing Donor Heart Allocation System Changes","volume":"5","author":"AS Varshney","year":"2020","journal-title":"JAMA Cardiol"},{"key":"pone.0247789.ref016","article-title":"Outcomes in the 2018 UNOS donor heart allocation system: A perspective on disparate analyses","author":"AS Varshney","year":"2020","journal-title":"J Heart Lung Transplant"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0247789","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T18:46:39Z","timestamp":1614710799000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0247789"}},"subtitle":[],"editor":[{"given":"Robert Jeenchen","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,3,2]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0247789","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,2]]}}}