Review of the allocation criteria for heart transplant in Spain in 2023. SEC-Heart Failure Association/ONT/SECCE consensus document

Rev Esp Cardiol (Engl Ed). 2024 Jan;77(1):69-78. doi: 10.1016/j.rec.2023.11.001. Epub 2023 Nov 4.
[Article in English, Spanish]

Abstract

Heart transplant (HT) remains the best therapeutic option for patients with advanced heart failure (HF). The allocation criteria aim to guarantee equitable access to HT and prioritize patients with a worse clinical status. To review the HT allocation criteria, the Heart Failure Association of the Spanish Society of Cardiology (HFA-SEC), the Spanish Society of Cardiovascular and Endovascular Surgery (SECCE) and the National Transplant Organization (ONT), organized a consensus conference involving adult and pediatric cardiologists, adult and pediatric cardiac surgeons, transplant coordinators from all over Spain, and physicians and nurses from the ONT. The aims of the consensus conference were as follows: a) to analyze the organization and management of patients with advanced HF and cardiogenic shock in Spain; b) to critically review heart allocation and priority criteria in other transplant organizations; c) to analyze the outcomes of patients listed and transplanted before and after the modification of the heart allocation criteria in 2017; and d) to propose new heart allocation criteria in Spain after an analysis of the available evidence and multidisciplinary discussion. In this article, by the HFA-SEC, SECCE and the ONT we present the results of the analysis performed in the consensus conference and the rationale for the new heart allocation criteria in Spain.

Keywords: Advanced heart failure; Asistencia circulatoria mecánica; Criterios de distribución de órgano sólido; Heart transplant; Insuficiencia cardiaca avanzada; Mechanical circulatory support; National Transplant Organization; Organización Nacional de Trasplantes; Solid organ allocation; Trasplante cardiaco.

MeSH terms

  • Adult
  • Child
  • Consensus
  • Heart Failure* / surgery
  • Heart Transplantation*
  • Humans
  • Shock, Cardiogenic
  • Spain / epidemiology