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Stanford Medicine’s new study reveals inconsistencies in the U.S. pediatric heart transplant waitlist, suggesting that the sickest patients are not always prioritized.
“The current system is not doing a good job of capturing medical urgency, which is one of its explicit goals,” said the study’s co-lead author, economist Kurt Sweat, PhD, who conducted the research as a graduate student in economics at Stanford University. Sweat shares lead authorship of the study with Alyssa Power, MD, who was a postdoctoral scholar in pediatric heart failure/transplant at Stanford Medicine when she worked on the study.
Pediatric donor hearts are in short supply, especially for infants and smaller children, as few children die in circumstances that allow their organs to be donated. Matching must account for several factors, including geographic locations of the donor and recipient, immune compatibility, and body size. The matching system is intended to prioritize sicker children for transplant and to function equitably.
The team compared how transplant candidates were actually ranked on the waitlist with how the candidates would have ranked if the listing order was based on medical urgency. Experts agree that a longer wait should not determine transplant priority, “because it can incentivize programs to list people early so you can build some wait time,” Almond said.
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