In April, the American College of Cardiology (ACC), American Heart Association (AHA) and the Heart Failure Society of America (HFSA) issued new joint guidelines for managing patients with heart failure. The most striking update to the guidelines is the addition of sodium-glucose co-transporter 2 inhibitors or SGLT2 inhibitors to guideline-directed medical therapy.

In 2021, more than 3,000 patients received a heart transplant in the United States and an additional 3,500 patients were awaiting transplantation. Expansion of the donor pool from a variety of factors has led to an increase in the number of heart transplants today compared to a decade ago. However, acute rejection, including acute cellular and antibody-mediated, continues to be a major source of morbidity and death among heart transplant recipients.

In 2018, the United Network of Organ Sharing (UNOS) and the Organ Procurement and Transplantation Network (OPTN) implemented a new allocation system for donor hearts with extended geographical sharing. The new system places patients in new medical urgency status classifications – Adult Status 1 through 6 – with specific status qualification criteria at listing.

A revolutionary new organ preservation system allows transplant programs to travel farther distances to procure donor hearts and provides the ability to better assess potential donor hearts that have borderline function. Approved by the FDA for use with donor hearts within the last 12 months, the organ care system is a portable, warm perfusion and monitoring system designed to keep a donor heart in a beating, human-like, metabolically active state.

Over the last several years, the new lung allocation system has resulted in broader, more equitable sharing of organs across the United States. At some individual transplant centers, this means wait times and the level of illness of patients on the waitlist are increasing.