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Donor organs are exceedingly scarce, so much so that one in five people on the waiting list for a heart transplant in the U.S. dies or is removed from the list before receiving a transplant.

In a new paper published in JAMA, researchers from the University of Chicago, in collaboration with federal policymakers, proposed a new organ allocation policy to address this problem by using a score that prioritizes waiting list candidates using objective, laboratory-based measurements of heart failure.

In an analysis of more than 45,000 "match runs" that generate a ranked list of transplant candidates, the new system did a better job of prioritizing the sickest patients for transplant than the current system, which is based on the treatments patients receive.

"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," said William F. Parker, M.D., Ph.D., associate professor of medicine and public health sciences at UChicago and senior author of the study. "We took a really important step closer to the goal of developing an objective medical urgency score for heart transplant."

S. Candidate Risk Score (US-CRS), a new measure first described by Parker and his team in another JAMA paper in 2024. US-CRS is designed to predict the likelihood that a patient will die if they don't receive a heart transplant within six weeks of being placed on the waiting list.

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