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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 18, 2025; 15(4): 108226
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.108226
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.108226
Impact of the United Network for Organ Sharing allocation criteria changes on temporary mechanical circulatory support use as a bridge to transplant
Sriram Sunil Kumar, Maisha Maliha, Sumant Pargaonkar, Vikyath Satish, Sharanya Kaushik, Kuan-Yu Chi, Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY 10461, United States
Shreya Arvind, Department of Internal Medicine, University of Connecticut, New Britain, CT 06030, United States
Sanjana Nagraj, Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, United States
Nikolaos Diakos, Department of Cardiology, Texas Heart Institute, Houston, TX 77030, United States
Miguel Alvarez Villela, Department of Cardiology, Lenox Hill Hospital/Northwell Health, New York, NY 10075, United States
Co-corresponding authors: Sanjana Nagraj and Miguel Alvarez Villela.
Author contributions: Sunil Kumar S and Arvind S conceptualized and designed the review, performed the literature search, analyzed and interpreted the data, wrote the original draft, and revised the manuscript; Nagraj S assisted with study design and contributed to manuscript review; Maliha M, Pargaonkar P, Satish V, Kaushik S, and Chi KY contributed to review and editing of the manuscript; Diakos N contributed to critical revision and review of the manuscript; Alvarez MA supervised the project and contributed to the conceptualization, review and critical revision of the manuscript. Nagraj S and Villela MA are given the position of co-corresponding authors because they have had independent and complementary leadership in the process of review. Nagraj S was specifically invited by the journal to make a submission as a token of appreciation for her work and expertise in the field. She handled all the correspondence with the journal pre-submission, from responding to the first queries to descriptions of submission guidelines, and making sure that the manuscript conformed to the standards of the journal before submitting. Additionally, Nagraj S coordinated communication between all the co-authors, handled feedback, and ensured the timely completion of every version. Villela MA, as the principal author and project supervisor, provided critical feedback and direction for the conceptualization and execution of the review. He played a decisive role in determining the trajectory of the research, maintaining methodological accuracy, and ensuring high academic standards. Villela MA also contributed heavily to the critical review of the manuscript and was accountable for the overall excellence of the work.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest relevant to the content of this manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Miguel Alvarez Villela, MD, Department of Cardiology, Lenox Hill Hospital/Northwell Health, New York, NY 10075, United States. malvarezvill@northwell.edu
Received: April 9, 2025
Revised: May 14, 2025
Accepted: June 13, 2025
Published online: December 18, 2025
Processing time: 224 Days and 23.7 Hours
Revised: May 14, 2025
Accepted: June 13, 2025
Published online: December 18, 2025
Processing time: 224 Days and 23.7 Hours
Core Tip
Core Tip: With the introduction of the new allocation system for heart transplants in 2018, there has been a change in the usage of temporary and durable mechanical circulatory devices. Reports from multiple registries have shown that the biggest change was noticed with the use of intra-aortic balloon pumps, which grant the second highest status within the current transplantation system. While this represents deficiencies in determining medical urgency within the current system, the proposed continuous allocation model and candidate risk score aim to provide equitable distribution of donor hearts.