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J Thorac Cardiovasc Surg 2006;131:775-776
© 2006 The American Association for Thoracic Surgery

Editorial

Allocating hearts

Cleveland Clinic Foundation, Cleveland, Ohio

Received for publication November 11, 2005; accepted for publication November 18, 2005.

^_* Address for reprints: Nicholas G. Smedira, MD, Cleveland Clinic Foundation, 9500 Euclid Avenue Desk F24, Cleveland, OH 44195 (Email: smedirn@ccf.org).

The first 20% of the full text of this article appears below.

As of August 5, 2005 there were 96,189 patients awaiting organ transplantation. During 2004 only 27,036 transplants were performed, highlighting a growing disparity between patients listed and organs available. The United Network for Organ Sharing (UNOS) is charged with coordinating the sharing of organs to ensure fairness and optimal utilization, and they also monitor the outcomes of all listed and transplanted patients. This wealth of information, which is accessible to the medical community and patients, was analyzed by Dr. Mokadam and colleagues, ¹ and as a result, they have raised concerns about the welfare of patients listed as status 2 (not inotrope-dependent, usually at home; patients listed as status 1A are hospitalized on devices or inotropes and patients listed as status 1B are on inotropes) during their prolonged wait for a heart transplant. Of the 1265 patients analyzed, 30% deteriorated and 10% died. Before responding to these concerns, I would like to take a closer look at how patients are doing while waiting for a heart transplant.

Since 1994, there has been a dramatic and unanticipated decline in the annual number of heart transplants performed in the United States. As reported by UNOS, during the past decade, heart transplants have been declining at a rate of 1% to 2% per year from a peak of 2528 in . . . [Full Text of this Article]

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Deterioration and mortality among patients with United Network for Organ Sharing status 2 heart disease: Caution must be exercised in diverting organs

Nahush A. Mokadam, Gregory A. Ewald, Ralph J. Damiano, Jr, and Nader Moazami
J. Thorac. Cardiovasc. Surg. 2006 131: 925-926. [Extract] [Full Text] [PDF]

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