OR02-5
Impact of UNOS Policy Changes on Intra-aortic balloon pump Utilization and Heart Transplantation Odds
Presenter
Laith Alhuneafat, University of Minnesota, minneapolis, MN
Laith Alhuneafat, University of Minnesota, minneapolis, MN, Fares Ghanem, Southern Illinois University, Springfield, IL, Adee Elhamdani, MD, Joan C Edwards School of Medicine - Marshall University, Huntington, WV and Ahmad Jabri, M.D., Henry Ford Health, Detroit, MI
Keywords: Cardiogenic Shock and Hemodynamic Support
Background
In cardiogenic shock, Intra-aortic balloon pump (IABP) support enhances hemodynamics and acts as a bridge to heart transplant. The 2018 UNOS policy change elevated the waitlist status for IABP-supported patients to Status 2. This study assesses the impact of this policy on IABP utilization and the odds of receiving transplant.
Methods
We analyzed IABP utilization trends among adult heart transplant candidates before and after the 2018 UNOS policy changes, comparing transplant and non-heart transplant centers across 2016-2020. Regression models explored the odds of receiving a heart transplant with IABP use.
Results
Among 4,134,324 decompensated heart failure hospitalizations, 399,230 occurred at heart transplant centers. IABP utilization for hemodynamic support increased during the study period, only in transplant centers, with a significant surge in 2019 (trend p < 0.001), while non-transplant centers saw no notable change. Patients listed with IABPs after the policy change had a 3.2-fold higher likelihood of receiving a transplant when compared to before policy change.
Conclusions
The implementation of the new heart transplantation allocation system significantly influenced IABP utilization in transplant centers. Patients listed with IABPs post-policy change exhibited a substantially increased likelihood of receiving heart transplants.
