【Background】 In heart transplantation, with the rapid increase of bridge-to-transplant using an implantable left ventricular assist device and the continued donor shortage, the average waiting period is exceeding 3 years with unneglectable death on the waiting list. Therefore, it is crucial to reduce the waiting mortality possibly by expansion of the donor pool and revision of the heart allocation system.
【Objective】 The aim is to provide the basic information about mortality on the waiting list for heart transplantation in Japan.
【Methods】 The national data accumulated in Japan Organ Transplant Network from 1997 to the end of 2018 was utilized. The death on the waiting list was analyzed by survival curves for the categories of basic disease, age-group (under 11, 11 to under 18, over 18 years), and Status-1, 2 and 3.
【Results】 Among the total listed patients of 1,629, 26.5% received transplantation but 22.8% died on the list. The survival curves demonstrated that there was no significant difference in the age groups or between Status-1 and 2. In Status-1, 32% of all waiting deaths occurred during the first 6 months.
【Conclusion】 High mortality on the waiting list for heart transplantation was documented and detailed risk analysis of early death on the waiting list is needed to provide basic data for the amendment of the current heart allocation system.
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