FRIDAY, Oct. 23, 2026 (HealthDay News) -- A U.S.-Candidate Risk Score (US-CRS) prioritizes sicker heart transplant candidates with higher mortality without transplant compared with the current medical urgency status, according to a study published online Oct. 12 in the Journal of the American Medical Association.
Grace R. Lyden, Ph.D., from Hennepin Healthcare Research Institute in Minneapolis, and colleagues conducted a registry-based observational study using data from the U.S. organ transplant system to develop a new heart allocation policy based on an objective medical urgency score. All adult heart transplant candidates from January 2019 to August 2025 were included and split into training, validation, and test datasets (21,859, 7,897, and 8,256 patients, respectively).
The US-CRS model included five laboratory variables and four therapeutic devices. The researchers found that US-CRS had a similar or significantly higher time-dependent area under the curve (AUC) than the current six-status system in test-set cross-sections of candidates actively waiting on the same calendar date (mean AUC, 0.807 versus 0.693) and acceptable calibration by status, especially for those candidates who received their status by exception. The US-CRS-based system led to 67 percent of transplant recipients moving down in rank order in a match-run analysis (45,530 donor hearts) and increased observed six-week transplant-censored mortality for the first candidate on the match run from 11.2 to 15.7 percent under the current system and the US-CRS-based systems, respectively.
"Our match run analysis of an actual novel policy is strongly suggestive that if we move from the current system to this policy, we could save even more lives with heart transplant," coauthor William F. Parker, M.D., Ph.D., from the University of Chicago, said in a statement.
Several authors disclosed ties to the pharmaceutical industry.
