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Purpose of Review <p>The U.S. organ transplant system operates under policies set forth by the Organ Procurement and Transplantation Network (OPTN) to coordinate allocation of transplantable organs. This paper examines recent policy changes and their impact on older transplant candidates.</p> Recent Findings <p>The 2018 heart transplant allocation policy change expanded the existing tier system to promote prioritization of critically ill patients, but studies indicate that older candidates may be less likely to meet high-urgency criteria. Continuous distribution allocation poses similar challenges to older populations, with models indicating worsened outcomes. Simultaneously, ongoing efforts to improve performance monitoring may further disincentivize transplantation of these candidates.</p> Summary <p>Adults over the age of 65 are increasingly in need of transplantation but disproportionately challenged by policy changes. While efforts to improve transplant system efficiency promote reliance on performance metrics, it is vital that system modernization does not inadvertently reduce equitable treatment of older adults.</p>

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Transplant Policy Changes Impacting Older Transplant Candidates

  • 期刊论文

  • 发表日期：

    2025年8月23日

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  • Amanda Buster,
  • Macey Leigh Levan

摘要

Purpose of Review

The U.S. organ transplant system operates under policies set forth by the Organ Procurement and Transplantation Network (OPTN) to coordinate allocation of transplantable organs. This paper examines recent policy changes and their impact on older transplant candidates.

Recent Findings

The 2018 heart transplant allocation policy change expanded the existing tier system to promote prioritization of critically ill patients, but studies indicate that older candidates may be less likely to meet high-urgency criteria. Continuous distribution allocation poses similar challenges to older populations, with models indicating worsened outcomes. Simultaneously, ongoing efforts to improve performance monitoring may further disincentivize transplantation of these candidates.

Summary

Adults over the age of 65 are increasingly in need of transplantation but disproportionately challenged by policy changes. While efforts to improve transplant system efficiency promote reliance on performance metrics, it is vital that system modernization does not inadvertently reduce equitable treatment of older adults.