OPTN/SRTR 2024 Annual Data Report: Heart

Monica M. Colvin^1,2, Jodi M. Smith^1,3, Colin T. Stomberski^1,2*, Yoon Son Ahn¹, Kelsi A. Lindblad⁴, Eric H. Messick⁴, Dzhuliyana Handarova⁴, Allyson Hart^1,5, Jon J. Snyder^1,5,6

¹Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN

²Department of Cardiology, University of Michigan, Ann Arbor, MI

³Department of Pediatrics, University of Washington, Seattle, WA

⁴Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA

⁵Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN

⁶Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN

*These authors contributed equally to this work

Abstract

In 2024, the total number of heart transplants in the United States reached a record of 4,636, an 81.5% increase since 2013. Of these, 4,146 occurred in adults while 490 occurred in pediatric recipients (93.5% and 19.2% increases, respectively, since 2013). This growth has been insufficient to meet the demand, as the number of adult patients awaiting transplant has always far exceeded the number of transplants performed. This is compounded by increasing numbers of new listings, although new adult listings have increased to a lesser extent (by 57.0%) than adult transplants since 2013. Pediatric heart transplants have only increased 19.2% since 2013, with an apparent plateau since 2018. Except for pediatric candidates aged 12-17 years and those who turned 18 while waiting, there has been a decline in heart transplant rates since 2013: in candidates younger than 1 year, a 48.2% decrease (123.6 [in 2024] versus 238.5 [in 2013] transplants per 100 patient-years); in those aged 1-5 years, a 41.4% decrease (54.0 versus 92.1 transplants per 100 patient-years); and in those aged 6-11 years, an 18.2% decrease (71.0 versus 86.8 transplants per 100 patient-years). The prevalence of heart donors after circulatory death increased to 17.9%. Pretransplant mortality in adults declined slightly, to 8.4 deaths per 100 patient-years, and in pediatric candidates reached a 10-year low of 8.2 deaths per 100 patient-years. Most adult heart transplants (54.9%) were performed at adult status 2, while most pediatric heart transplants (88.8%) were performed at status 1A. There were 974 transplants performed in adults with Impella only, 716 with intra-aortic balloon pump only, and 189 with extracorporeal membrane oxygenation only. The 1- and 5-year survival after transplant remained stable (for transplants in 2017-2019): 91.2% and 80.1% in adults and 92.3% and 83.9% in pediatric recipients, respectively. Two-year survival was lowest in recipients listed at adult status 5 (79.3%) and highest in recipients listed at adult status 6 (91.1%).

Keywords: Allocation, donor, heart failure, heart transplant, left ventricular assist device, mechanical circulatory support, outcomes

1 Introduction

The past year has been a pivotal one for the transplant community in the United States, marked by Organ Procurement and Transplantation Network (OPTN) modernization, the continuous distribution initiative in heart transplant, heightened concerns regarding allocation out of OPTN sequence (AOOS), and looming health care changes. Despite these shifts, allocation policies continue to evolve in response to this complex and dynamic landscape. One of the key challenges to the heart transplant community is the need to develop policies that reflect the nuanced clinical profiles of the adult heart transplant candidate in the 21st century, as well as evolving perspectives on listing strategies. At the time of publication of this report, we begin the eighth year since the last major revision to the adult heart allocation policy in 2018, and it is evident that more precise definitions and risk stratification are needed. Notably, trends within adult statuses 2 and 4 are beginning to mirror historical concerns associated with former statuses 1A and 1B. Recently, a revision to criteria for percutaneous endovascular mechanical circulatory support device and intra-aortic balloon pump (IABP) use within adult status 2 was approved by the OPTN Board in December 2023 and implemented in September 2025.¹ This policy was developed in response to increased numbers of patients being listed at adult status 2 with similar risk of death to patients listed at adult status 3. Policy changes on the horizon include escalation of status for patients supported by long-term left ventricular assist device (LVAD) use. In addition, the heart transplant community had been preparing for implementation of continuous distribution; however, this initiative has been temporarily deferred to allow policy development related to AOOS.

This latest Annual Data Report reveals no major surprises for 2024. Encouragingly, adult heart transplant volumes and waiting times continued to show positive trends, and pediatric waitlist mortality dropped below 10%—a first in more than a decade. Multiorgan transplants continued to increase; however, candidates listed at adult status 5 continued to have lower transplant rates and higher waitlist mortality compared with some higher acuity statuses. This raises questions regarding alignment of the current multiorgan allocation policy with existing listing criteria at adult status 5. In this edition of the Annual Data Report, we introduce data on trends in specific temporary mechanical circulatory support (tMCS) devices for the first time. We anticipate future reports will provide even more comprehensive insights.

2 Adult Heart Transplant

2.1 Waitlist Trends

In 2024, the trend of high turnover on the adult heart transplant waiting list continued. However, as compared with the previous 2 years, in 2024, more patients were added to the adult heart transplant waiting list than were removed (Table HR 5). Although there were also more transplants performed in 2024 compared with the prior 2 years and a 93.5% increase since 2013 (Figure HR 41), more patients remained on the list at the end of the year. The number of new adult heart transplant candidates added to the waiting list continues to increase annually, with a 33.8% increase in new patient listings in 2024 when compared to 2020, and a 57.0% increase since 2013. The largest increase in new listings in the past decade, 616, occurred between 2022 and 2023 (Figure HR 1). In general, there have been no significant shifts in candidate characteristics including age, sex, and diagnosis (Figure HR 3, Figure HR 4, Figure HR 6, Table HR 1, and Table HR 2). However, since 2013, there has been a 30.7% increase in candidates with a body mass index (BMI) of 35 kg/m² or greater, and a 28.4% decrease and 12.3% decrease in candidates with BMI less than 18.5 kg/m² and 18.5-<25 kg/m², respectively (Figure HR 10). While the proportion of White candidates has decreased since 2013, the proportions of those in the other racial and ethnic categories have increased, including a 42.8% increase in Asian candidates, a 25.1% increase in Black candidates, a 70.3% increase in Hispanic candidates, and a 29.8% increase in Native American candidates (candidates classified as Native American or Multiracial made up 1.1% of all adult heart candidates) (Figure HR 5). Listing for coronary artery disease continued to decrease in prevalence, and in 2024 was 27.6%. As a historical reference, cardiomyopathy first surpassed coronary artery disease among heart candidates in 2004, likely due to improved management of ischemic heart disease (2011 Annual Data Report). More recently, there has been improvement in identifying cardiomyopathies via genetic testing and other modalities.² Among adult candidates on the waiting list at any point during the year, most, 50.7%, spent less than 90 days on the list in 2024, compared with 29.1% in 2013 (a 74.4% increase); the proportion of candidates on the list for 2 years or more declined to 15.1% (Figure HR 7). Duration on the waiting list includes removal for any reason; however, this shift to shorter durations reflects rapid turnover of higher urgency candidates and new additions to the list.

Since implementation of the 2018 heart transplant allocation policy, there has been rapid growth in candidates listed at adult status 1 (9.3% in 2024 versus 4.2% in 2019 [a 121.6% increase]) and adult status 2 (31.0% in 2024 versus 20.2% in 2019 [a 53.3% increase]), with concomitant declines in those listed at adult status 3 (7.2% in 2024 versus 11.7% in 2019 [a 38.3% decrease]) and adult status 4 (25.8% in 2024 versus 31.9% in 2019 [a 19.2% decrease]) (Figure HR 9). These changes reflect increased use of extracorporeal membrane oxygenation (ECMO), IABP, and Impella to improve access to transplant after implementation of the 2018 allocation policy. Overall, these trends stabilized between 2023 and 2024 for adult statuses 2 through 4; however, the proportion of candidates listed at adult status 1 rose to 9.3% in 2024 from 7.8% in 2023 (an 18.6% increase). High-urgency listings (adult statuses 1-3) accounted for 47.5% of all adult heart transplant listings in 2024, which represents a 31.5% increase since 2019. Initially following the 2018 policy, most candidates were adult status 4, but around 2022, a shift occurred to more listings at adult status 2. Heart candidate listing trends by donor service area showed that regions had a median of 31.2% patients listed at adult status 2 in 2024. Additionally, between 2023 and 2024, there was a noticeable increase in adult status 1 listings in regions 1, 2, 3, 8, and 9 (Table HR 4), with the largest such increase in region 8 (83.7% year-to-year increase).

2.2 Heart Transplant Rates

The overall adult heart transplant rate rose to 138.7 heart transplants per 100 patient-years in 2024 compared with 65.9 in 2013 (a 110.5% increase). From 2015 through 2023, there were annual increases in the heart transplant rate; however, between 2023 and 2024, there was no substantial change in the number of heart transplants per 100 patient-years (138.7 in 2024 versus 140.8 in 2023) (Figure HR 14). This may represent a new equilibrium following years of rapid transplant expansion due to transplants from hepatitis C–positive donors and from donation after circulatory death (DCD) donors. Candidates aged 65 years or older had the highest heart transplant rate at 174.0 transplants per 100 patient-years (Figure HR 15). All other adult age categories showed a small decline in the number of heart transplants in 2024 relative to 2023. The heart transplant rates have risen for candidates of all races and ethnicities compared with rates in 2013 (Figure HR 16). In 2024, candidates classified in the Other category (Native American, Multiracial, and unreported) had the highest heart transplant rate at 249.5 transplants per 100 patient-years. Stable compared with 2023, the heart transplant rate among Black candidates was the lowest at 122.4 transplants per 100 patient-years. Candidates in the remaining racial and ethnic categories had slight decreases in transplant rates.

By diagnosis group, the highest rate of heart transplant continued to be in candidates with valvular heart disease, at 190.1 transplants per 100 patient-years in 2024, compared with 64.5 in 2013 (a 194.8% increase). The heart transplant rates for the other diagnosis groups, including coronary artery disease, cardiomyopathy, congenital heart disease, and other/unknown, remained higher than those in 2013 but were stable from 2023 (Figure HR 17). Congenital heart disease continued to have the lowest heart transplant rate at 95.3 transplants per 100 patient-years. For cardiomyopathy, coronary artery disease, and other/unknown diagnosis, the heart transplant rates were roughly equivalent at 144.9, 134.2, and 139.1 transplants per 100 patient-years, respectively. Since 2018, there has been a noticeable increase in the rate of heart transplants in female candidates as compared with male candidates; in 2024, their rates were 182.3 and 127.6 transplants per 100 patient-years, respectively (Figure HR 19).

Since 2019, there has been a slight rise in the heart transplant rate for candidates in the adult status 1 urgency group (1932.1 transplants per 100 patient-years in 2024 versus 1647.9 in 2019 [a 17.2% increase]) and a slight decline in the rate for candidates listed at adult status 2 (1003.2 transplants per 100 patient-years in 2024 versus 1170.5 in 2019 [a 14.3% decrease]) (Figure HR 21). Transplant rates for adult statuses 3-5 were stable, and the rate for adult status 6 rose to 73.4 transplants per 100 patient-years in 2024 compared with 54.6 in 2019 (a 34.4% increase).

For new candidates listed in 2021, 75.8% of them had undergone transplant within 3 years (Figure HR 25), which was similar to those listed in 2020 (74.0%) (2023 Annual Data Report). Only 6.0% of candidates remained on the waiting list after 3 years; 14.2% were delisted and 4.0% died prior to transplant. Waiting times are likely decreasing as more candidates receive transplant within 1 year of listing (Figure HR 24). In 2023, 60.6% of patients had undergone heart transplant within 3 months (a 109.5% increase since 2013); 67.7% of patients, within 6 months (a 70.0% increase since 2013); and 73.0% of patients, within 1 year (a 43.7% increase since 2013).

2.3 Pretransplant Mortality

Pretransplant mortality in adult heart transplant candidates declined 41.6% between 2013 and 2019 then has remained stable since 2019; in 2024 and 2019, the rates were 8.4 and 8.7 deaths per 100 patient-years, respectively, compared with 14.9 in 2013 (Figure HR 26). Pretransplant mortality has declined in all age groups since 2013 and, in 2024, remained highest in transplant candidates older than 65 years at 12.8 deaths per 100 patient-years (Figure HR 27). After generally declining in candidates of all races and ethnicities since 2013, pretransplant mortality rates in 2024 were similar among the Black, Hispanic, White, and Other groups (Figure HR 28); however, there was an uptick in pretransplant mortality in Asian candidates, with 20.7 deaths per 100 patient-years in 2024 compared with 10.5 in 2023 (a 98.2% increase). When stratified by diagnosis, pretransplant mortality was lowest in 2024 in those with cardiomyopathy, congenital heart disease, and valvular heart disease at 7.2, 7.2, and 7.4 deaths per 100 patient-years, respectively (Figure HR 30). Pretransplant mortality was slightly higher in candidates with coronary artery disease (9.8 deaths per 100 patient-years) and highest in those in the other/unknown diagnosis category (15.5). Pretransplant mortality was similar between candidates with metropolitan and nonmetropolitan residence at 8.2 and 10.8 deaths per 100 patient-years, respectively (Figure HR 31), and ranged from 0 to 26.2 across donor service areas (Figure HR 34).

Pretransplant mortality has generally declined for all adult medical urgency groups since 2013, although in adult status 1 candidates it varied widely between 2019 and 2024; pretransplant mortality peaked at 149.1 deaths per 100 patient-years in 2022 then was 99.7 in 2024 (Figure HR 33). This variation is likely attributed to excess cardiovascular deaths during the COVID-19 pandemic, a situation that is improving with return to normalcy. In 2024, owing to their acuity, candidates listed at adult status 1 had the highest rate of pretransplant mortality (99.7 deaths per 100 patient-years), while those listed at adult status 6 had the lowest rate at 4.0 (Figure HR 33). Candidates listed at adult status 5 (multiorgan transplant; 16.5 deaths per 100 patient-years) continued to have higher rates of pretransplant mortality than those listed at adult status 3 (10.6) or adult status 4 (4.1), likely due to the complexity of their multiorgan failure.

Death within 6 months after removal from the heart waiting list reached a new low of 11.0% in 2024, compared with 32.6% in 2013—a 66.2% decrease (Figure HR 35). While the percentages of death within 6 months of removal from the list declined for all of the age groups 35 years or older between 2022 and 2024, the percentage for candidates aged 18-34 years had a 252.2% increase over the same time frame: 13.0% in 2024 versus 3.7% in 2022 (Figure HR 36). Death within 6 months after removal from the heart transplant waiting list were relatively stable across racial and ethnic groups in 2024 with no major outliers (Figure HR 37). Candidates listed at adult statuses 4 or 6 had the lowest mortality within 6 months of removal: 2.0% and 2.3%, respectively (Figure HR 39). Not surprisingly, those with adult statuses 1-3 had the highest mortality within 6 months of removal in 2024 (adult status 1, 20.0%; adult status 2, 26.1%; and adult status 3, 20.0%). Candidates listed at adult status 5 and candidates temporarily inactive also had appreciable 6-month mortality: 12.5% and 11.7%, respectively.

2.4 Heart Transplant Trends

In 2024, there were 4,636 overall heart transplants performed in the United States (Figure HR 40), which represents an 81.5% increase compared with 2013. Of these, 4,146 (89.4%) were adult heart transplants, a 93.5% increase in adult transplants from 2,143 in 2013 (Figure HR 41). Year-over-year, there were an additional 54 adult heart transplants done from 2023 to 2024, which is the smallest annual increase in the prior decade after several years of triple-digit increases in volume (prior smallest annual increase: 77 from 2016-2017). As expected, heart transplants have risen across all age categories since 2013, with the highest increase occurring in candidates aged 50-64 years: 1,966 transplants in 2024 compared with 1,011 in 2013 (a 94.5% increase) (Figure HR 42). Between 2023 and 2024, transplant volume in candidates aged 18-49 years declined slightly while it continued to rise, albeit minimally, in candidates aged 50 years or older. Heart transplants increased across all racial and ethnic groups since 2013, with notable gains for Asian (137.3% increase), Black (134.7% increase), Hispanic (256.6% increase), and Native American (125.0% increase) recipients and more modest gains for White (55.4% increase) and Multiracial recipients (37.5% increase) in 2024 (Figure HR 44). Compared with 2023, transplant volume declined in Native American (18 in 2024 versus 32 in 2023 [a 43.8% decrease]) and White (2,226 versus 2,339 [a 4.8% decrease]) transplant recipients and increased modestly in other racial and ethnic groups.

Transplants for all heart failure diagnoses have increased since 2013 (Figure HR 45), although transplants for valvular heart failure have not increased dramatically (57 in 2024 versus 45 in 2013 [a 26.7% increase]) as compared to other groups, such as cardiomyopathy (2,592 versus 1,197 [a 116.5% increase]). In 2024, 54.9% of recipients were adult status 2 at transplant. Since 2020, heart transplants have increased substantially for adult status 1 (694 in 2024 versus 264 in 2020 [a 162.9% increase]) and adult status 2 (2,277 versus 1,435 [a 58.7% increase]); have declined for adult status 3 (418 versus 588 [a 28.9% decrease]), adult status 4 (490 versus 737 [a 33.5% decrease]), and adult status 5 (40 versus 46 [a 13.0% decrease]); and have increased modestly for adult status 6 (208 versus 168 [a 23.8% increase]) (Figure HR 46). This continues the trend of fewer transplants from adult status 4, which primarily comprises patients with LVAD (without complications) and those with congenital heart disease, and lends further validity to concerns that these patients may have excessive transplant waiting times. The continued decline in heart transplants from adult status 3 likely reflects higher use of tMCS (IABP, Impella, ECMO, as detailed below) to improve access to heart transplant by granting higher listing status (adult status 2). Only 40 patients from adult status 5 underwent transplant in 2024; this may be due to the higher acuity of multiorgan failure patients and listing at higher adult heart status. Under the multiorgan allocation policy implemented in February 2022, for candidates requiring heart-liver transplant, a liver is only required to be allocated with the heart from the same donor in heart candidates listed at adult statuses 1-3. Thus, for some multiorgan candidates, there is no utility in being listed as adult status 5.³ Overall, multiorgan transplants have increased significantly since 2013, with heart-kidney transplant being the most common (367 in 2024 versus 85 in 2013 [a 331.8% increase]) (Figure HR 47). Heart-lung and heart-liver transplants have increased 262.5% and 343.8% since 2013, respectively. After rising from 2013 to 2022, multiorgan transplants have been essentially stable since 2022.

The implementation of the 2018 heart transplant allocation policy update considerably changed the utilization of life support devices at the time of transplant. In 2017, 8.8% of transplants occurred in patients with either ECMO alone or IABP alone (the OPTN did not record Impella separately at this time, and the LVAD category includes both temporary and durable left ventricular support devices); in 2019, 33.1% of transplants occurred in patients with either ECMO alone or IABP alone, representing a 308.8% increase in ECMO alone and IABP alone (not including tMCS implanted in combination with other devices) following implementation of the 2018 policy revision (Figure HR 48). IABP use (alone or in combination) peaked in 2021, at 952, then had a 16.9% decrease to 791 in 2024, due to increased use of Impella (Table HR 7). Impella was first reported in the OPTN database in 2021, with four transplant recipients with Impella support. In 2023, the Impella 5.5 (previously categorized as LVAD or other) was added to the OPTN database. Use of Impella prior to transplant has steadily increased to 1,103 transplant recipients in 2024, representing 26.6% of candidates supported by Impella either alone or in combination with other life support devices or vasoactive therapies (Table HR 7). Transplant from ECMO as the only life support device declined to 189 in 2024, after having peaked in 2023 with 226 transplants (which had been a 65.0% increase compared with 2019). However, overall ECMO use continued to rise, as 368 transplants (8.9% of total transplants) were performed from ECMO support in 2024 as compared with 234 (6.9%) in 2021 (Table HR 7), likely from increased combination support with ECMO and Impella. Indeed, combination mechanical life support device therapy (which includes LVAD and tMCS) prior to transplant has risen significantly since 2019 (203 in 2024 versus 61 in 2019 [a 232.8% increase]) (Figure HR 48). In 2024, Impella surpassed IABP as the most common tMCS at transplant, with 974 recipients with Impella alone versus 716 with IABP alone. In all, 45.3% of transplants were supported by either Impella alone, ECMO alone, or IABP alone in 2024 compared with 31.9% in 2021. Transplant from LVAD alone (dischargeable or nondischargeable) peaked in 2016, with 1,288 transplants, and declined to 600 transplants in 2024 (a 53.4% decrease). Otherwise, there were 1,464 transplants without tMCS or durable LVAD support in 2024, after having peaked in 2023 at 1,942 transplants (a 24.6% year-to-year decrease); this trend may be partially explained by reclassification of Impella 5.5 from other categories to the Impella category. Taken together, the mechanical circulatory support data show that tMCS use increased rapidly after implementation of the 2018 adult heart policy revision, which corresponds to both increased adult status 1 and adult status 2 listings and decreased heart transplant waiting times at those statuses over that period. In addition, Impella use has increased rapidly since 2021, and transplant from LVAD continues to steadily decline.

In 2024, the typical adult heart transplant recipient was male, aged 50-64 years, White, blood type O, without a VAD, calculated panel-reactive antibody (cPRA) less than 1%, and listed at adult status 2 at the time of transplant. In addition, the typical recipient had private insurance, lived within 50 miles of the transplant center, and lived in a metropolitan area (Table HR 8 and Table HR 9).

Induction therapy use continues to fluctuate on a yearly basis, and overall use of induction therapy remained around 50% in 2024 (Figure HR 51). When used, interleukin-2 agents have been more common than T-cell–depleting agents (28.4% versus 19.3% in 2024), and dual-agent therapy has remained very rare (Figure HR 52). By far, most adult heart transplant recipients are discharged on triple immunosuppressive therapy with tacrolimus, a mycophenolate agent, and a steroid, and this increased to 89.7% of recipients in 2024 (Figure HR 53). In the past decade, the incidence of acute rejection at 1 year posttransplant has decreased among all age groups: age 18-34 years, 18.4% in 2023 versus 31.1% in 2013; age 35-49 years, 20.0% in 2023 versus 26.6% in 2013; age 50-64 years, 17.1% in 2023 versus 21.5% in 2013; and 65 years or older, 14.3% in 2024 versus 17.7% in 2013 (Figure HR 68).

In 2024, 146 centers in the United States performed at least one adult or pediatric heart transplant, a 15.9% increase from 126 centers in 2013 (Figure HR 54). Most transplant centers perform 1-25 heart transplants per year (Figure HR 55).

2.5 Posttransplant Survival and Morbidity

Adult posttransplant mortality has remained stable over the past decade. Between 2013 and 2023, 6-month mortality ranged from 6.5% to 8.8%, 1-year mortality ranged from 7.9% to 10.8%, 3-year mortality ranged from 13.7% to 16.0%, and 5-year mortality has been around 20% (Figure HR 56). Among adult heart transplant patients who underwent transplant in 2017-2019, the 5-year survival rate was 80.1% (similar to the 80.3% in the 2016-2018 cohort from the 2023 report); the 1-year survival rate was 91.2% and the 3-year survival rate was 85.6% (Figure HR 57). Within this cohort, older patients had early decrements in survival compared with recipients aged 18-34 and 35-49 years; patients aged 65 years or older at the time of transplant had the greatest decline in survival in the first year, to 89.7%, compared with patients in those younger age groups both having survival of 93.0% at 1 year. Overall, a similar trend continued through 5-year follow-up, where survival in recipients older than 65 at the time of transplant was 77.6% at 5 years and 80.0% or greater in all other age cohorts (Figure HR 58). Survival at 1 year was similar among all racial and ethnic groups (range, 90.8% to 92.0%) except in the Other group (88.7%); survival at 3 years was similar among all groups (range, 84.0% to 86.3%). At 5 years, survival was highest in Asian and White heart transplant recipients at 81.9% and 81.4%, respectively; it was lowest in Black recipients at 76.6% (Figure HR 59).

In the 2017-2019 adult heart transplant cohort, recipients who underwent transplant for congenital heart disease continued to have the lowest survival at early time points compared to recipients with other diagnoses; they had a decrease in survival of greater than 10% within the first 4 months (Figure HR 60). At 1 year, survival in the congenital heart disease diagnosis group was 86.2% and it was 89.3% for those who had coronary artery disease; the other diagnosis groups had survival greater than 90.0%. Recipients with congenital heart disease and coronary artery disease continued to have lower survival at 3 and 5 years as well. For 5-year survival, recipients in the coronary artery disease group had survival of 76.5% and those in the congenital heart disease group had survival of 77.9%; those with cardiomyopathy, valvular heart disease, and other/unknown diagnosis had survival greater than or equal to 82.0%. Transplant recipient survival did not vary greatly by sex (Figure HR 61) or the presence of ventricular assist device at the time of transplant (Figure HR 62).

Among heart transplant recipients in 2021-2022, posttransplant survival varied based on adult status at the time of transplant. At 6 months posttransplant, survival was lowest among those who underwent transplant at adult status 5 (85.1%) and was also less than 90% in those who underwent transplant at adult status 1 (88.6%) (Figure HR 64); survival at 6 months through year 2 posttransplant was similar between those who received transplant at adult statuses 2, 3, 4, and 6. The 2-year survival rate was 84.0% for adult status 1 and 79.3% for status 5. Only those who received transplant at adult status 6 had greater than 90% survival (91.1%) at 2 years.

In patients who underwent multiorgan transplant in 2017-2019, heart-kidney and heart-liver recipients had similar outcomes with 79.2% and 80.9% survival at 5 years, respectively (Figure HR 66). These outcomes were similar to that of heart-only recipients in the same time frame (80.4%). Heart-lung recipients continued to show the lowest survival: 83.7% at 1 year, 70.7% at 3 years, and 60.9% at 5 years. Only 15 “other multiorgan” transplants were done during this time frame, which skews the survival results due to low volume. Patients who underwent heart transplant in 2017-2019 with cPRA values of 98-100% had the lowest survival at all time points. At 5 years, survival was lower for patients who underwent transplant with a cPRA of 80-100% when compared to those with cPRA of 0-<80% (Figure HR 67).

3 Donation

Deceased heart donors reached a new peak in 2024 at 4,711 total donor hearts (adult and pediatric) (Figure HR 70). This represents an 82.5% increase from 2013; however, it represents only a 1.0% increase in deceased heart donor count from 2023 (4,664 donor hearts). In contrast, there was an 8.3% increase in deceased heart donors from 2021 to 2022 and a 10.4% increase from 2022 to 2023. In general, over the past decade there has been a trend toward older donor hearts (Figure HR 71). In 2013, most hearts came from donors aged 18-29 years; however, the numbers of hearts recovered from those aged 30-39 years and 40-54 years have risen sharply since 2015, and donor hearts from the 30-39 age group are now the most common. In 2024, donor hearts recovered from those aged 40-54 years continued to increase, to 1,296, whereas hearts from donors aged 18-29 years declined to 1,351 (from 1,470 in 2023) and those from donors aged 30-39 years declined to 1,413 (from 1,525 in 2023)—these three age groups contributed 86.2% of donor hearts in 2024. Donor trends remained stable by sex (Figure HR 73) and race and ethnicity (Figure HR 74).

Expansion to include hearts from DCD donors and donors who are hepatitis C virus (HCV) positive has improved access to transplant in the preceding decade. Hearts from those with HCV (by nucleic acid testing [NAT] or antibody [Ab] testing) represented 8.5% of donor hearts in 2024, up from 0.6% in 2016. NAT+ donor hearts represented 3.9% of hearts recovered for transplant in 2024, up from 0.4% in 2016 and down from a peak of 6.7% in 2019; Ab+/NAT- donor hearts represented 4.6% in 2024, up from 0.2% in 2016 and similar to a peak of 4.9% in 2023 (Figure HR 75). Peak HCV-positive heart donation occurred in 2019 and 2021, where HCV-positive hearts accounted for about 10%. Whether HCV-positive donor hearts continue to downtrend will be worth noting in the coming years. Since 2019, DCD heart donation has steadily risen and has facilitated an increasing number of heart transplants. In 2024, DCD hearts represented 17.9% of donated hearts, up from 14.0% in 2023 and compared with just 0.2% in 2019 (Figure HR 76).

The cause of death among donors has shifted over the past decade. In 2024, head trauma accounted for 36.0% of donor deaths compared with 53.1% in 2013 (a 32.1% decrease). At the same time, anoxia being the cause of death in 47.9% of donors in 2024 represents an 80.9% increase since 2013 (26.5%) and was the most frequent cause of death. In 2024, CVA/stroke was the cause of death in 12.5% of heart donors, down from 17.6% in 2013 (a 28.8% decrease) (Figure HR 77).

Hearts recovered for transplant and not transplanted (nonuse) continued to increase in 2024. Since reaching a nadir in 2018 (0.7%), the nonuse rate rose to 1.9% in 2024 (181.5% increase) in conjunction with the increased recovery of both older hearts and DCD hearts (Figure HR 78). The nonuse rate continues to fluctuate over time across multiple categories, but in general it rose across all donor characteristic categories in 2024: age (Figure HR 79), sex (Figure HR 80), race and ethnicity (Figure HR 81), hypertension status (Figure HR 82), BMI (Figure HR 83), cause of death (Figure HR 84), and risk of disease transmission (Figure HR 85).

4 Pediatric Heart Transplant

4.1 Waitlist Trends

In 2024, there were 716 new pediatric candidates added to the transplant waiting list, up 15.3% from 2013 (Figure HR 86). There were 1,231 total pediatric candidates listed in 2024, representing a 29.0% increase from 2013 (Figure HR 87). The largest pediatric age group on the waiting list in 2024 was 1-5 years (28.4%), followed by candidates aged 12-17 years (24.4%), those aged 6-11 years (23.7%), and those younger than 1 year (17.3%) (Figure HR 88). Candidates who turned age 18 on the waiting list who were listed when younger than 18 years represented 6.3% of candidates (Figure HR 88). In terms of race and ethnicity, 46.5% of candidates were White, 22.3% were Hispanic, 20.8% were Black, 3.4% were Asian, and 3.3% were Multiracial, with 3.0% having this information unreported (Figure HR 89). Congenital heart defects were the most common diagnosis among pediatric candidates (58.7%), followed by other/unknown (17.2%), idiopathic dilated cardiomyopathy (15.4%), familial dilated cardiomyopathy (3.7%), myocarditis (2.8%), and idiopathic restrictive cardiomyopathy (2.2%) (Figure HR 90). Most pediatric transplant candidates lived in a metropolitan area (84.3%) and less than 50 miles (51.2%) from a transplant center (Table HR 12). There has been an increase in the proportion of pediatric candidates on the waiting list with VAD support: 15.5% in 2024 versus 4.6% in 2014 (Table HR 13). Over the course of 2024, there were 657 pediatric heart transplant candidates removed from the list, of whom 509 (77.5%) underwent transplant, 45 (6.8%) died, 41 (6.2%) improved and transplant was no longer needed, 24 (3.7%) were too sick for transplant, 3 (0.5%) refused at the time of transplant offering, and 35 (5.3%) were removed for Other reasons (Table HR 15 and Table HR 16).

The proportion of pediatric heart transplant candidates on the waiting list for less than 90 days continued to decline, to 32.0% in 2024 from 47.8% in 2013 (a 33.1% decrease) (Figure HR 92). All waiting time categories besides less than 90 days have increased compared with 2013, with the largest increase in those waiting 6-<12 months for heart transplant: 18.5% in 2024 from 11.5% in 2013 (a 60.9% increase) (Figure HR 92). In 2024, just over half of pediatric heart transplant candidates were listed at status 1A (53.0%), followed by 17.1% at status 1B and 8.4% at status 2 (Figure HR 93).

In 2024, the pediatric heart transplant rate fell to 92.2 transplants per 100 patient-years, compared to 121.9 in 2013 (a 24.4% decrease) (Figure HR 94). By age, the highest rate of pediatric heart transplant occurred among candidates aged 12-17 years at 171.9 transplants per 100 patient-years, a 15.2% increase from 2013 (Figure HR 95). The lowest rate (22.6 transplants per 100 patient years) occurred in pediatric candidates in the 18 years or older category. Since 2013, the heart transplant rate in candidates younger than 1 year has decreased 48.2% (2024 versus 2013: 123.6 versus 238.5 transplants per 100 patient-years), decreased by 41.4% in those aged 1-5 years (54.0 versus 92.1), and decreased by 18.2% in those aged 6-11 years (71.0 versus 86.8). Pediatric transplant rates were similar among racial and ethnic groups in 2024 (Figure HR 96). For newly listed pediatric heart transplant candidates in 2019-2021, 73.2% of candidates underwent heart transplant within 3 years, 14.0% were removed from the list, 8.0% died prior to transplant, and 4.8% were still on the waiting list (Figure HR 98).

Pretransplant mortality among pediatric candidates waiting for heart transplant continued its overall decline over the past decade. Pretransplant mortality has declined 56.5%: 8.2 deaths per 100 patient-years in 2024 compared with 18.8 in 2013 (Figure HR 99). In 2024, pretransplant mortality in pediatric candidates was highest in those younger than 1 year at 17.7 deaths per 100 patient-years, although this was significantly lower than in 2023 (30.5). The pretransplant mortality rates in those aged 1-5 years, 6-11 years, and 12-17 years were 9.9, 2.6, and 6.2 deaths per 100 patient-years, respectively (Figure HR 100). Looking at race and ethnicity, pretransplant mortality was highest in Asian candidates at 16.4 deaths per 100 patient-years, followed by those in the Other (14.1), Hispanic (10.6), White (7.2), and Black groups (4.9) (Figure HR 101). By diagnosis, pediatric heart transplant candidates with myocarditis had the highest pretransplant mortality in 2024 (16.2 deaths per 100 patient-years); with the exception of familial dilated cardiomyopathy (0.0), the rates in the other diagnosis groups were similar to each other (range, 5.3 to 9.3) (Figure HR 102). Candidates listed at status 1A had the highest pretransplant mortality rate at 22.0 deaths per 100 patient-years (Figure HR 103).

4.2 Trends in Heart Transplant

In 2024, 490 pediatric heart transplants were performed, representing a 19.2% increase from 411 transplants in 2013 (Figure HR 105). By age, there were 181 (36.9%) heart transplant recipients aged 12-17 years, 108 (22.0%) recipients aged 1-5 years, 105 (21.4%) recipients aged 6-11 years, and 96 (19.6%) recipients aged younger than 1 year (Figure HR 106). By race and ethnicity, there were 233 (47.6%) White pediatric heart transplant recipients, 104 (21.2%) Black recipients, 101 (20.6%) Hispanic recipients, 19 (3.9%) Asian recipients, 17 (3.5%) Multiracial recipients, and 16 (3.3%) recipients in the unreported group; there were no Native American recipients (Figure HR 108). Since 2013, the largest gains in heart transplant have occurred among Multiracial recipients (a 183.3% increase) and Hispanic recipients (a 26.3% increase). Pediatric heart transplant recipients were most likely to undergo transplant for congenital heart defects: 273 (55.8%) in 2024 (a 54.2% increase since 2013). Rates of transplant for other diagnoses have been mostly stable for the past decade (Figure HR 109).

Most pediatric heart transplant recipients underwent transplant from status 1A (88.8%), followed by 9.4% from status 1B and 1.8% from status 2 (Figure HR 110 and Table HR 19). Around 30% of pediatric heart transplant recipients were supported by LVAD at the time of transplant (Table HR 17), which is similar to the rate in 2019. Very few pediatric heart transplant recipients were supported by tMCS; however, there has been a noticeable increase in the use of Impella, with 23 pediatric patients supported by this device before transplant in 2024 (Table HR 17 and Figure HR 112) compared with none prior to 2023. Despite this, tMCS remains infrequently used in the pediatric population when compared with the adult population. Most pediatric heart transplants in 2024 came from donation after brain death donors (476 [97.1%]). Still, 14 (2.9%) DCD heart transplants were performed in pediatric recipients in 2024 (Table HR 20). The proportion of ABO-incompatible transplants increased to 8.0% in 2024, from 4.4% in 2014. In 2024, there were 10 multiorgan transplants in pediatric heart transplant recipients: 5 heart-kidney, 3 heart-lung, and 2 heart-liver.

The combination of a donor who was positive for cytomegalovirus or Epstein-Barr virus (EBV) and a pediatric recipient who was negative occurred in 31.2% and 31.1%, respectively, of transplant recipients in 2022-2024 (Table HR 21). For transplants in 2013-2019, incidence of posttransplant lymphoproliferative disorder among EBV-negative recipients was 7.0% at 5 years posttransplant, compared with 4.2% among EBV-positive recipients (Figure HR 124).

Use of induction therapy has increased since 2013, with 86.5% of pediatric heart transplant recipients having received induction therapy in 2024 (Figure HR 114). In contrast to adult recipients, pediatric heart transplant recipients were most likely to receive T-cell–depleting therapy alone (76.3%). Interleukin-2 receptor antibody induction was used in 9.4% of recipients and combination induction therapy was used in 0.8% of recipients (Figure HR 115). The most common initial immunosuppression regimen used in pediatric heart transplant recipients in 2024 was triple therapy with tacrolimus, a mycophenolate agent, and corticosteroids (53.3%) (Figure HR 116).

4.3 Posttransplant Survival and Morbidity

Pediatric heart transplant survival has remained stable over the past decade. Starting in 2013, 6-month mortality posttransplant has ranged from 3.6% to 7.3%; 1-year mortality, from 5.2% to 10.0%; 3-year mortality, from 10.2% to 15.1%; 5-year mortality, from 13.7% to 17.8%; and 10-year mortality, around 25.8% (Figure HR 117). Among pediatric heart transplant recipients in 2017-2019, patient survival rates at 1, 3, and 5 years posttransplant were 92.3%, 87.8%, and 83.9% (Figure HR 118). Five-year patient survival rates by recipient age at the time of heart transplant were 82.7%, 83.3%, 87.7%, and 83.2% for patients aged younger than 1 year, 1-5 years, 6-11 years, and 12-17 years, respectively (Figure HR 119). By race and ethnicity, 5-year patient survival was highest for Asian recipients at 87.0%, followed by White recipients at 86.0%; Hispanic recipients, 83.3%; Black recipients, 79.4%; and those categorized as Other, 76.7% (Figure HR 120). Patient survival varied by cause of heart failure, with 5-year survival highest in those who had idiopathic restrictive cardiomyopathy at 91.4%, followed by idiopathic dilated cardiomyopathy, 88.9%; familial dilated cardiomyopathy, 87.3%; other/unknown, 87.1%; myocarditis, 81.6%; and congenital heart disease, 80.2% (Figure HR 121). Looking at medical urgency status, 5-year pediatric patient survival was 82.8% among status 1A recipients, 88.6% among status 1B recipients, and 85.7% among status 2 recipients (Figure HR 122). In 2023, the incidence of acute rejection at 1 year posttransplant in pediatric heart transplant recipients was highest in those aged 12-17 years (11.4%), followed by those aged 6-11 years (10.6%), 1-5 years (8.6%), and younger than 1 year (7.6%) (Figure HR 123).

References

Organ Procurement and Transplantation Network. OPTN Heart Transplantation Committee. Notice of OPTN Policy and Data Collection Changes: Amend Adult Heart Status 2 Mechanical Device Requirements. Published online 2023. Accessed October 10, 2025. https://optn.transplant.hrsa.gov/media/guvjtmkr/policy-notice_amend-heart-status-2-mechanical-device-requirements_nov2023_update.pdf

Hofmeyer M, Haas GJ, Jordan E, Cao J, Kransdorf E, Ewald GA, Morris AA, Owens A, Lowes B, Stoller D, Wilson Tang WH, Garg S, Trachtenberg BH, Shah P, Pamboukian SV, Sweitzer NK, Wheeler MT, Wilcox JE, Katz S, Pan S, Jimenez J, Smart F, Wang J, Gottlieb SS, Judge DP, Moore CK, Huggins GS, Kinnamon DD, Ni H, Hershberger RE, DCM Precision Medicine Study of the DCM Consortium. Rare variant genetics and dilated cardiomyopathy severity: The DCM Precision Medicine Study. Circulation. 2023;148(11):872-881. doi:10.1161/CIRCULATIONAHA.123.064847

Organ Procurement and Transplantation Network. Notice of OPTN Policy Changes. Establish Eligibility Criteria and Safety Net for Heart-Kidney and Lung-Kidney Allocation. Published online 2022. Updated 2023. Accessed July 29, 2025. https://optn.transplant.hrsa.gov/media/erucde2m/policy-notice_est-elgblty-crit-and-safety-for-hrt-kid-and-lung-kid-alloc_mot.pdf

Support, Copyright, and Citation Information

This publication was produced for the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), by Hennepin Healthcare Research Institute (HHRI) and the United Network for Organ Sharing (UNOS) under contracts HHSH75R60220C00011/HHSH75R60226C00003 and HHSH250201900001C, respectively.

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Suggested Citations:

Full citation: Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients (SRTR). OPTN/SRTR 2024 Annual Data Report. U.S. Department of Health and Human Services, Health Resources and Services Administration; 2026. Accessed [insert date]. https://srtr.transplant.hrsa.gov/annualdatareports
Abbreviated full citation: OPTN/SRTR 2024 Annual Data Report. HHS/HRSA; 2026. Accessed [insert date]. https://srtr.transplant.hrsa.gov/annualdatareports
Chapter citation: [Authors]. OPTN/SRTR 2024 Annual Data Report: [chapter]. Accessed [insert date]. https://srtr.transplant.hrsa.gov/annualdatareports
Chapter citation for AJT e-supplement available at amjtransplant.org: [Authors]. OPTN/SRTR 2024 Annual Data Report: [chapter]. Am J Transplant. 2026;26([issue and suppl numbers]):[page range]. [doi]

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List of Figures

Figure HR 1: New adult candidates added to the heart transplant waiting list
Figure HR 2: All adult candidates on the heart transplant waiting list
Figure HR 3: Distribution of adult candidates waiting for heart transplant by age
Figure HR 4: Distribution of adult candidates waiting for heart transplant by sex
Figure HR 5: Distribution of adult candidates waiting for heart transplant by race and ethnicity
Figure HR 6: Distribution of adult candidates waiting for heart transplant by diagnosis
Figure HR 7: Distribution of adult candidates waiting for heart transplant by waiting time
Figure HR 8: Distribution of adult candidates waiting for heart transplant by former medical urgency groups through October 17, 2018
Figure HR 9: Distribution of adult candidates waiting for heart transplant by current medical urgency groups, October 18, 2018, through 2024
Figure HR 10: Distribution of adult candidates waiting for heart transplant by BMI
Figure HR 11: Distribution of adult candidates waiting for heart transplant by blood type
Figure HR 12: Distribution of adult candidates waiting for heart transplant by prior heart transplant status
Figure HR 13: Distribution of adult candidates waiting for heart transplant by active status
Figure HR 14: Overall deceased donor heart transplant rates among adult waitlist candidates
Figure HR 15: Deceased donor heart transplant rates among adult waitlist candidates by age
Figure HR 16: Deceased donor heart transplant rates among adult waitlist candidates by race and ethnicity
Figure HR 17: Deceased donor heart transplant rates among adult waitlist candidates by diagnosis
Figure HR 18: Deceased donor heart transplant rates among adult waitlist candidates by blood type
Figure HR 19: Deceased donor heart transplant rates among adult waitlist candidates by sex
Figure HR 20: Deceased donor heart transplant rates among adult waitlist candidates by former medical urgency groups through October 17, 2018
Figure HR 21: Deceased donor heart transplant rates among adult waitlist candidates by current medical urgency groups, October 18, 2018, through 2024
Figure HR 22: Deceased donor heart transplant rates among adult waitlist candidates by height
Figure HR 23: Deceased donor heart transplant rates among adult waitlist candidates by metropolitan versus nonmetropolitan residence
Figure HR 24: Percentages of adults who underwent deceased donor heart transplant within a given period of listing
Figure HR 25: Three-year outcomes for adults waiting for heart transplant, new listings in 2021
Figure HR 26: Overall pretransplant mortality rates among adult candidates waitlisted for heart transplant
Figure HR 27: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by age
Figure HR 28: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by race and ethnicity
Figure HR 29: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by sex
Figure HR 30: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by diagnosis
Figure HR 31: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by metropolitan versus nonmetropolitan residence
Figure HR 32: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by former medical urgency groups through October 17, 2018
Figure HR 33: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by current medical urgency groups, October 18, 2018, through 2024
Figure HR 34: Pretransplant mortality rates among adult candidates waitlisted for heart transplant in 2024 by DSA
Figure HR 35: Percentages of deaths within 6 months after removal among adult heart waitlist candidates overall
Figure HR 36: Percentages of deaths within 6 months after removal among adult heart waitlist candidates by age
Figure HR 37: Percentages of deaths within 6 months after removal among adult heart waitlist candidates by race and ethnicity
Figure HR 38: Percentages of deaths within 6 months after removal among adult heart waitlist candidates by sex
Figure HR 39: Percentages of deaths within 6 months after removal among adult heart waitlist candidates by status at removal
Figure HR 40: Overall heart transplants
Figure HR 41: Overall adult heart transplants
Figure HR 42: Adult heart transplants by recipient age
Figure HR 43: Adult heart transplants by sex
Figure HR 44: Adult heart transplants by race and ethnicity
Figure HR 45: Adult heart transplants by diagnosis
Figure HR 46: Adult heart transplants by medical urgency
Figure HR 47: Adult heart transplants by multiorgan transplant type
Figure HR 48: Adult heart transplants by life support device type
Figure HR 49: Adult heart transplants by number of life support treatments
Figure HR 50: Adult heart transplants by distance between donor and center
Figure HR 51: Induction agent use in adult heart transplant recipients
Figure HR 52: Type of induction agent use in adult heart transplant recipients
Figure HR 53: Immunosuppression regimen use in adult heart transplant recipients
Figure HR 54: Number of centers performing at least one pediatric or adult heart transplant
Figure HR 55: Number of centers performing at least one pediatric or adult heart transplant by number of transplants performed
Figure HR 56: Percentages of patient deaths among adult heart transplant recipients
Figure HR 57: Patient survival among adult heart transplant recipients, 2017-2019
Figure HR 58: Patient survival among adult heart transplant recipients, 2017-2019, by age
Figure HR 59: Patient survival among adult heart transplant recipients, 2017-2019, by race and ethnicity
Figure HR 60: Patient survival among adult heart transplant recipients, 2017-2019, by diagnosis group
Figure HR 61: Patient survival among adult heart transplant recipients, 2017-2019, by sex
Figure HR 62: Patient survival among adult heart transplant recipients, 2017-2019, by VAD status
Figure HR 63: Patient survival among adult heart transplant recipients, 2017-2019, by former medical urgency
Figure HR 64: Patient survival among adult heart transplant recipients, 2021-2022, by current medical urgency
Figure HR 65: Patient survival among adult heart transplant recipients, 2017-2019, by metropolitan versus nonmetropolitan recipient residence
Figure HR 66: Patient survival among adult heart transplant recipients, 2017-2019, by multiorgan transplant type
Figure HR 67: Patient survival among adult heart transplant recipients, 2017-2019, by cPRA
Figure HR 68: Incidence of acute rejection by 1 year posttransplant among adult heart transplant recipients by age
Figure HR 69: Incidence of PTLD among adult heart transplant recipients by recipient EBV status at transplant, 2013-2019
Figure HR 70: Overall deceased heart donor count
Figure HR 71: Deceased heart donor count by age
Figure HR 72: Distribution of deceased heart donors by age
Figure HR 73: Distribution of deceased heart donors by sex
Figure HR 74: Distribution of deceased heart donors by race and ethnicity
Figure HR 75: Distribution of deceased heart donors by donor HCV status
Figure HR 76: Distribution of deceased heart donors by DBD and DCD status
Figure HR 77: Cause of death among deceased heart donors
Figure HR 78: Overall percentages of hearts recovered for transplant and not transplanted
Figure HR 79: Percentages of hearts recovered for transplant and not transplanted by donor age
Figure HR 80: Percentages of hearts recovered for transplant and not transplanted by donor sex
Figure HR 81: Percentages of hearts recovered for transplant and not transplanted by donor race and ethnicity
Figure HR 82: Percentages of hearts recovered for transplant and not transplanted by donor hypertension status
Figure HR 83: Percentages of hearts recovered for transplant and not transplanted by donor BMI
Figure HR 84: Percentages of hearts recovered for transplant and not transplanted by donor cause of death
Figure HR 85: Percentages of hearts recovered for transplant and not transplanted, by donor risk of disease transmission
Figure HR 86: New pediatric candidates added to the heart transplant waiting list
Figure HR 87: All pediatric candidates on the heart transplant waiting list
Figure HR 88: Distribution of pediatric candidates waiting for heart transplant by age
Figure HR 89: Distribution of pediatric candidates waiting for heart transplant by race and ethnicity
Figure HR 90: Distribution of pediatric candidates waiting for heart transplant by diagnosis
Figure HR 91: Distribution of pediatric candidates waiting for heart transplant by sex
Figure HR 92: Distribution of pediatric candidates waiting for heart transplant by waiting time
Figure HR 93: Distribution of pediatric candidates waiting for heart transplant by medical urgency
Figure HR 94: Overall deceased donor heart transplant rates among pediatric waitlist candidates
Figure HR 95: Deceased donor heart transplant rates among pediatric waitlist candidates by age
Figure HR 96: Deceased donor heart transplant rates among pediatric waitlist candidates by race and ethnicity
Figure HR 97: Deceased donor heart transplant rates among pediatric waitlist candidates by metropolitan versus nonmetropolitan residence
Figure HR 98: Three-year outcomes for newly listed pediatric candidates waiting for heart transplant, 2019-2021
Figure HR 99: Overall pretransplant mortality rates among pediatric candidates waitlisted for heart transplant
Figure HR 100: Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by age
Figure HR 101: Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by race and ethnicity
Figure HR 102: Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by diagnosis
Figure HR 103: Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by medical urgency
Figure HR 104: Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by metropolitan versus nonmetropolitan residence
Figure HR 105: Overall pediatric heart transplants
Figure HR 106: Pediatric heart transplants by recipient age
Figure HR 107: Pediatric heart transplants by sex
Figure HR 108: Pediatric heart transplants by race and ethnicity
Figure HR 109: Pediatric heart transplants by diagnosis
Figure HR 110: Pediatric heart transplants by medical urgency
Figure HR 111: Pediatric heart transplants by distance between donor and center
Figure HR 112: Pediatric heart transplants by life support device type
Figure HR 113: Pediatric heart transplants by number of life support treatments
Figure HR 114: Induction agent use in pediatric heart transplant recipients
Figure HR 115: Type of induction agent use in pediatric heart transplant recipients
Figure HR 116: Immunosuppression regimen use in pediatric heart transplant recipients
Figure HR 117: Percentages of patient deaths among pediatric heart transplant recipients
Figure HR 118: Overall patient survival among pediatric deceased donor heart transplant recipients, 2017-2019
Figure HR 119: Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by recipient age
Figure HR 120: Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by race and ethnicity
Figure HR 121: Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by diagnosis
Figure HR 122: Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by medical urgency
Figure HR 123: Incidence of acute rejection by 1 year posttransplant among pediatric heart transplant recipients by age
Figure HR 124: Incidence of PTLD among pediatric heart transplant recipients by recipient EBV status at transplant, 2013-2019

List of Tables

Table HR 1: Demographic characteristics of adults on the heart transplant waiting list on December 31, 2014, and December 31, 2024
Table HR 2: Clinical characteristics of adults on the heart transplant waiting list on December 31, 2014, and December 31, 2024
Table HR 3: Listing characteristics of adults on the heart transplant waiting list on December 31, 2014, and December 31, 2024
Table HR 4: Medical urgency statuses 1 and 2 of adults on the heart transplant waiting list by OPTN region during 2023 and 2024
Table HR 5: Heart transplant waitlist activity among adults
Table HR 6: Removal reason among adult heart transplant candidates
Table HR 7: Adult heart transplant recipients on life support before transplant
Table HR 8: Demographic characteristics of adult heart transplant recipients, 2014 and 2024
Table HR 9: Clinical characteristics of adult heart transplant recipients, 2014 and 2024
Table HR 10: Transplant characteristics of adult heart transplant recipients, 2014 and 2024
Table HR 11: Adult heart donor-recipient serology matching, 2022-2024
Table HR 12: Demographic characteristics of pediatric candidates on the heart transplant waiting list on December 31, 2014, and December 31, 2024
Table HR 13: Clinical characteristics of pediatric candidates on the heart transplant waiting list on December 31, 2014, and December 31, 2024
Table HR 14: Listing characteristics of pediatric candidates on the heart transplant waiting list on December 31, 2014, and December 31, 2024
Table HR 15: Heart transplant waitlist activity among pediatric candidates
Table HR 16: Removal reason among pediatric heart transplant candidates
Table HR 17: Pediatric heart transplant recipients on life support before transplant
Table HR 18: Demographic characteristics of pediatric heart transplant recipients, 2014 and 2024
Table HR 19: Clinical characteristics of pediatric heart transplant recipients, 2014 and 2024
Table HR 20: Transplant characteristics of pediatric heart transplant recipients, 2014 and 2024
Table HR 21: Pediatric heart donor-recipient serology matching, 2022-2024

**New adult candidates added to the heart transplant waiting list.** A new adult candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Active and inactive patients are included.

Figure HR 1: New adult candidates added to the heart transplant waiting list. A new adult candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Active and inactive patients are included.

**All adult candidates on the heart transplant waiting list.** Adult candidates on the list at any time during the year. Candidates listed at more than one center are counted once per listing.

Figure HR 2: All adult candidates on the heart transplant waiting list. Adult candidates on the list at any time during the year. Candidates listed at more than one center are counted once per listing.

**Distribution of adult candidates waiting for heart transplant by age.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included. Age is determined at the earliest of transplant, death, removal, or December 31 of the year.

Figure HR 3: Distribution of adult candidates waiting for heart transplant by age. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included. Age is determined at the earliest of transplant, death, removal, or December 31 of the year.

**Distribution of adult candidates waiting for heart transplant by sex.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure HR 4: Distribution of adult candidates waiting for heart transplant by sex. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

**Distribution of adult candidates waiting for heart transplant by race and ethnicity.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure HR 5: Distribution of adult candidates waiting for heart transplant by race and ethnicity. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

**Distribution of adult candidates waiting for heart transplant by diagnosis.** Candidates waiting for transplant at any time in the given year. Active and inactive patients are included. Candidates listed at more than one center are counted once per listing.

Figure HR 6: Distribution of adult candidates waiting for heart transplant by diagnosis. Candidates waiting for transplant at any time in the given year. Active and inactive patients are included. Candidates listed at more than one center are counted once per listing.

**Distribution of adult candidates waiting for heart transplant by waiting time.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Time on the waiting list is determined at the earliest of transplant, death, removal, or December 31 of the year. Active and inactive candidates are included.

Figure HR 7: Distribution of adult candidates waiting for heart transplant by waiting time. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Time on the waiting list is determined at the earliest of transplant, death, removal, or December 31 of the year. Active and inactive candidates are included.

**Distribution of adult candidates waiting for heart transplant by former medical urgency groups through October 17, 2018.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included. The October 2018 OPTN heart allocation policy update changed the status groups. Medical urgency for 2017 and earlier is determined at the earliest of transplant, death, removal, or December 31 of the year. For 2018 medical urgency statuses, statuses 1A, 1B, and 2 were determined at the earliest of transplant, death, or removal. For candidates who stayed active on the waiting list on or after October 18, 2018, and for candidates who were newly waitlisted on or after that date, their statuses are shown in Figure HR 9. Inactive statuses with new listings on or after October 18, 2018, are excluded here in Figure HR 8.

Figure HR 8: Distribution of adult candidates waiting for heart transplant by former medical urgency groups through October 17, 2018. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included. The October 2018 OPTN heart allocation policy update changed the status groups. Medical urgency for 2017 and earlier is determined at the earliest of transplant, death, removal, or December 31 of the year. For 2018 medical urgency statuses, statuses 1A, 1B, and 2 were determined at the earliest of transplant, death, or removal. For candidates who stayed active on the waiting list on or after October 18, 2018, and for candidates who were newly waitlisted on or after that date, their statuses are shown in Figure HR 9. Inactive statuses with new listings on or after October 18, 2018, are excluded here in Figure HR 8.

**Distribution of adult candidates waiting for heart transplant by current medical urgency groups, October 18, 2018, through 2024.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included. The October 2018 OPTN heart allocation policy update changed the status groups. Medical urgency is determined at the earliest of transplant, death, removal, or December 31 of the year. For 2018 medical urgency statuses, adult statuses 1-6 and inactive status contain new listings on or after October 18, 2018, or existing listings from before the policy change.

Figure HR 9: Distribution of adult candidates waiting for heart transplant by current medical urgency groups, October 18, 2018, through 2024. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included. The October 2018 OPTN heart allocation policy update changed the status groups. Medical urgency is determined at the earliest of transplant, death, removal, or December 31 of the year. For 2018 medical urgency statuses, adult statuses 1-6 and inactive status contain new listings on or after October 18, 2018, or existing listings from before the policy change.

**Distribution of adult candidates waiting for heart transplant by BMI.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included. BMI, body mass index.

Figure HR 10: Distribution of adult candidates waiting for heart transplant by BMI. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included. BMI, body mass index.

**Distribution of adult candidates waiting for heart transplant by blood type.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure HR 11: Distribution of adult candidates waiting for heart transplant by blood type. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

**Distribution of adult candidates waiting for heart transplant by prior heart transplant status.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure HR 12: Distribution of adult candidates waiting for heart transplant by prior heart transplant status. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

**Distribution of adult candidates waiting for heart transplant by active status.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included. Active status is determined at the earliest of transplant, death, removal, or December 31 of the year.

Figure HR 13: Distribution of adult candidates waiting for heart transplant by active status. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included. Active status is determined at the earliest of transplant, death, removal, or December 31 of the year.

**Overall deceased donor heart transplant rates among adult waitlist candidates.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

Figure HR 14: Overall deceased donor heart transplant rates among adult waitlist candidates. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

**Deceased donor heart transplant rates among adult waitlist candidates by age.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.

Figure HR 15: Deceased donor heart transplant rates among adult waitlist candidates by age. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.

**Deceased donor heart transplant rates among adult waitlist candidates by race and ethnicity.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. The Other race category is composed of Native American, Multiracial, and unreported categories.

Figure HR 16: Deceased donor heart transplant rates among adult waitlist candidates by race and ethnicity. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. The Other race category is composed of Native American, Multiracial, and unreported categories.

**Deceased donor heart transplant rates among adult waitlist candidates by diagnosis.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

Figure HR 17: Deceased donor heart transplant rates among adult waitlist candidates by diagnosis. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

**Deceased donor heart transplant rates among adult waitlist candidates by blood type.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

Figure HR 18: Deceased donor heart transplant rates among adult waitlist candidates by blood type. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

**Deceased donor heart transplant rates among adult waitlist candidates by sex.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

Figure HR 19: Deceased donor heart transplant rates among adult waitlist candidates by sex. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

**Deceased donor heart transplant rates among adult waitlist candidates by former medical urgency groups through October 17, 2018.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. The October 2018 OPTN heart allocation policy update changed the status groups. Medical urgency is determined at the later of listing date or January 1 of the given year. Inactive statuses with new listings on or after October 18, 2018, are excluded.

Figure HR 20: Deceased donor heart transplant rates among adult waitlist candidates by former medical urgency groups through October 17, 2018. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. The October 2018 OPTN heart allocation policy update changed the status groups. Medical urgency is determined at the later of listing date or January 1 of the given year. Inactive statuses with new listings on or after October 18, 2018, are excluded.

**Deceased donor heart transplant rates among adult waitlist candidates by current medical urgency groups, October 18, 2018, through 2024.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. The October 2018 OPTN heart allocation policy update changed the status groups. Medical urgency is determined at the later of listing date or January 1 of the given year. For 2018 medical urgency statuses, adult statuses 1-6 and inactive status contain new listings on or after October 18, 2018.

Figure HR 21: Deceased donor heart transplant rates among adult waitlist candidates by current medical urgency groups, October 18, 2018, through 2024. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. The October 2018 OPTN heart allocation policy update changed the status groups. Medical urgency is determined at the later of listing date or January 1 of the given year. For 2018 medical urgency statuses, adult statuses 1-6 and inactive status contain new listings on or after October 18, 2018.

**Deceased donor heart transplant rates among adult waitlist candidates by height.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

Figure HR 22: Deceased donor heart transplant rates among adult waitlist candidates by height. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

**Deceased donor heart transplant rates among adult waitlist candidates by metropolitan versus nonmetropolitan residence.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. Urban/rural determination is made using the RUCA (rural-urban commuting area) designation of the candidate's permanent zip code.

Figure HR 23: Deceased donor heart transplant rates among adult waitlist candidates by metropolitan versus nonmetropolitan residence. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. Urban/rural determination is made using the RUCA (rural-urban commuting area) designation of the candidate’s permanent zip code.

**Percentages of adults who underwent deceased donor heart transplant within a given period of listing.** Candidates listed at more than one center are counted once per listing.

Figure HR 24: Percentages of adults who underwent deceased donor heart transplant within a given period of listing. Candidates listed at more than one center are counted once per listing.

**Three-year outcomes for adults waiting for heart transplant, new listings in 2021.** Candidates listed at more than one center are counted once per listing. Removed from list includes all reasons except transplant and death. DD, deceased donor.

Figure HR 25: Three-year outcomes for adults waiting for heart transplant, new listings in 2021. Candidates listed at more than one center are counted once per listing. Removed from list includes all reasons except transplant and death. DD, deceased donor.

**Overall pretransplant mortality rates among adult candidates waitlisted for heart transplant.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

Figure HR 26: Overall pretransplant mortality rates among adult candidates waitlisted for heart transplant. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

**Pretransplant mortality rates among adult candidates waitlisted for heart transplant by age.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.

Figure HR 27: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by age. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.

**Pretransplant mortality rates among adult candidates waitlisted for heart transplant by race and ethnicity.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. The Other race category is composed of Native American, Multiracial, and unreported categories.

Figure HR 28: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by race and ethnicity. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. The Other race category is composed of Native American, Multiracial, and unreported categories.

**Pretransplant mortality rates among adult candidates waitlisted for heart transplant by sex.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

Figure HR 29: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by sex. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

**Pretransplant mortality rates among adult candidates waitlisted for heart transplant by diagnosis.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

Figure HR 30: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by diagnosis. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

**Pretransplant mortality rates among adult candidates waitlisted for heart transplant by metropolitan versus nonmetropolitan residence.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Urban/rural determination is made using the RUCA (rural-urban commuting area) designation of the candidate's permanent zip code.

Figure HR 31: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by metropolitan versus nonmetropolitan residence. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Urban/rural determination is made using the RUCA (rural-urban commuting area) designation of the candidate’s permanent zip code.

**Pretransplant mortality rates among adult candidates waitlisted for heart transplant by former medical urgency groups through October 17, 2018.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Medical urgency is determined at the later of listing date or January 1 of the given year. The October 2018 OPTN heart allocation policy update changed the status groups. For 2018 medical urgency statuses, new listings on or after October 18, 2018, are not shown in this figure.

Figure HR 32: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by former medical urgency groups through October 17, 2018. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Medical urgency is determined at the later of listing date or January 1 of the given year. The October 2018 OPTN heart allocation policy update changed the status groups. For 2018 medical urgency statuses, new listings on or after October 18, 2018, are not shown in this figure.

**Pretransplant mortality rates among adult candidates waitlisted for heart transplant by current medical urgency groups, October 18, 2018, through 2024.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Medical urgency is determined at the later of listing date or January 1 of the given year. The October 2018 OPTN heart allocation policy update changed the status groups. For 2018 medical urgency statuses, adult statuses 1-6 and inactive status contain new listings on or after October 18, 2018.

Figure HR 33: Pretransplant mortality rates among adult candidates waitlisted for heart transplant by current medical urgency groups, October 18, 2018, through 2024. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Medical urgency is determined at the later of listing date or January 1 of the given year. The October 2018 OPTN heart allocation policy update changed the status groups. For 2018 medical urgency statuses, adult statuses 1-6 and inactive status contain new listings on or after October 18, 2018.

**Pretransplant mortality rates among adult candidates waitlisted for heart transplant in 2024 by DSA.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. DSA, donation service area.

Figure HR 34: Pretransplant mortality rates among adult candidates waitlisted for heart transplant in 2024 by DSA. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. DSA, donation service area.

**Percentages of deaths within 6 months after removal among adult heart waitlist candidates overall.** Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list.

Figure HR 35: Percentages of deaths within 6 months after removal among adult heart waitlist candidates overall. Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list.

**Percentages of deaths within 6 months after removal among adult heart waitlist candidates by age.** Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list. Age is determined at removal.

Figure HR 36: Percentages of deaths within 6 months after removal among adult heart waitlist candidates by age. Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list. Age is determined at removal.

**Percentages of deaths within 6 months after removal among adult heart waitlist candidates by race and ethnicity.** Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list. The Other race category is composed of Native American, Multiracial, and unreported categories.

Figure HR 37: Percentages of deaths within 6 months after removal among adult heart waitlist candidates by race and ethnicity. Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list. The Other race category is composed of Native American, Multiracial, and unreported categories.

**Percentages of deaths within 6 months after removal among adult heart waitlist candidates by sex.** Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list.

Figure HR 38: Percentages of deaths within 6 months after removal among adult heart waitlist candidates by sex. Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list.

**Percentages of deaths within 6 months after removal among adult heart waitlist candidates by status at removal.** Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list. The October 2018 OPTN heart allocation policy update changed the status groups. The adult statuses listed are for October 18, 2018, and onward. Medical urgency is determined at the earliest of transplant, death, removal, or December 31 of the year.

Figure HR 39: Percentages of deaths within 6 months after removal among adult heart waitlist candidates by status at removal. Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list. The October 2018 OPTN heart allocation policy update changed the status groups. The adult statuses listed are for October 18, 2018, and onward. Medical urgency is determined at the earliest of transplant, death, removal, or December 31 of the year.

Figure HR 40: Overall heart transplants. All heart transplants, including adult and pediatric, retransplant, and multiorgan.

Figure HR 41: Overall adult heart transplants. All adult heart transplants, including retransplant and multiorgan.

**Adult heart transplants by recipient age.** All adult heart transplants, including retransplant and multiorgan. Age is recipient age at transplant.

Figure HR 42: Adult heart transplants by recipient age. All adult heart transplants, including retransplant and multiorgan. Age is recipient age at transplant.

Figure HR 43: Adult heart transplants by sex. All adult heart transplants, including retransplant and multiorgan.

Figure HR 44: Adult heart transplants by race and ethnicity. All adult heart transplants, including retransplant and multiorgan.

Figure HR 45: Adult heart transplants by diagnosis. All adult heart transplants, including retransplant and multiorgan.

**Adult heart transplants by medical urgency.** All adult heart transplants, including retransplant and multiorgan. The October 2018 OPTN heart allocation policy update changed the status groups. The statuses 1A, 1B, and 2 listed first are through October 17, 2018, the last day before the policy update; the adult statuses listed are for October 18, 2018, and onward.

Figure HR 46: Adult heart transplants by medical urgency. All adult heart transplants, including retransplant and multiorgan. The October 2018 OPTN heart allocation policy update changed the status groups. The statuses 1A, 1B, and 2 listed first are through October 17, 2018, the last day before the policy update; the adult statuses listed are for October 18, 2018, and onward.

Figure HR 47: Adult heart transplants by multiorgan transplant type. All adult heart transplants, including retransplant and multiorgan.

**Adult heart transplants by life support device type.** All adult heart transplants, including retransplant and multiorgan. LVAD only means dischargeable or nondischargeable LVAD. Combination means some combination of dischargeable LVAD, nondischargeable LVAD, ECMO, IABP, and/or Impella. If none of the above, heart recipients may have used another type of life support. ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device.

Figure HR 48: Adult heart transplants by life support device type. All adult heart transplants, including retransplant and multiorgan. LVAD only means dischargeable or nondischargeable LVAD. Combination means some combination of dischargeable LVAD, nondischargeable LVAD, ECMO, IABP, and/or Impella. If none of the above, heart recipients may have used another type of life support. ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device.

**Adult heart transplants by number of life support treatments.** All adult heart transplants, including retransplant and multiorgan. Use of the following life support treatments was assessed: dischargeable LVAD, nondischargeable LVAD, dischargeable RVAD, nondischargeable RVAD, ECMO, IABP, Impella, percutaneous device, total artificial heart, prostaglandin, inhaled nitric oxide, inotropes, and ventilator. None means transplant recipient did not receive any of these treatments. Single means transplant recipient received one type of these treatments, but not any other types. Multiple means transplant recipient received at least two types of these treatments. ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device; RVAD, right ventricular assist device.

Figure HR 49: Adult heart transplants by number of life support treatments. All adult heart transplants, including retransplant and multiorgan. Use of the following life support treatments was assessed: dischargeable LVAD, nondischargeable LVAD, dischargeable RVAD, nondischargeable RVAD, ECMO, IABP, Impella, percutaneous device, total artificial heart, prostaglandin, inhaled nitric oxide, inotropes, and ventilator. None means transplant recipient did not receive any of these treatments. Single means transplant recipient received one type of these treatments, but not any other types. Multiple means transplant recipient received at least two types of these treatments. ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device; RVAD, right ventricular assist device.

**Adult heart transplants by distance between donor and center.** All adult heart transplants, including retransplant and multiorgan. Distance between donor and center is computed from donor hospital to the transplant center.

Figure HR 50: Adult heart transplants by distance between donor and center. All adult heart transplants, including retransplant and multiorgan. Distance between donor and center is computed from donor hospital to the transplant center.

**Induction agent use in adult heart transplant recipients.** All adult heart transplants, including retransplant and multiorgan. Immunosuppression at transplant reported to the OPTN.

Figure HR 51: Induction agent use in adult heart transplant recipients. All adult heart transplants, including retransplant and multiorgan. Immunosuppression at transplant reported to the OPTN.

**Type of induction agent use in adult heart transplant recipients.** All adult heart transplants, including retransplant and multiorgan. Immunosuppression at transplant reported to the OPTN. IL2Ab, interleukin-2 receptor antibody; TCD, T-cell depleting.

Figure HR 52: Type of induction agent use in adult heart transplant recipients. All adult heart transplants, including retransplant and multiorgan. Immunosuppression at transplant reported to the OPTN. IL2Ab, interleukin-2 receptor antibody; TCD, T-cell depleting.

**Immunosuppression regimen use in adult heart transplant recipients.** All adult heart transplants, including retransplant and multiorgan. Immunosuppression regimen at transplant reported to the OPTN. MMF, all mycophenolate agents; Tac, tacrolimus.

Figure HR 53: Immunosuppression regimen use in adult heart transplant recipients. All adult heart transplants, including retransplant and multiorgan. Immunosuppression regimen at transplant reported to the OPTN. MMF, all mycophenolate agents; Tac, tacrolimus.

**Number of centers performing at least one pediatric or adult heart transplant.** Count of all centers that have performed at least one heart transplant.

Figure HR 54: Number of centers performing at least one pediatric or adult heart transplant. Count of all centers that have performed at least one heart transplant.

**Number of centers performing at least one pediatric or adult heart transplant by number of transplants performed.** Count of all centers that have performed at least one heart transplant.

Figure HR 55: Number of centers performing at least one pediatric or adult heart transplant by number of transplants performed. Count of all centers that have performed at least one heart transplant.

**Percentages of patient deaths among adult heart transplant recipients.** All adult recipients of deceased donor hearts, including multiorgan transplant recipients.

Figure HR 56: Percentages of patient deaths among adult heart transplant recipients. All adult recipients of deceased donor hearts, including multiorgan transplant recipients.

**Patient survival among adult heart transplant recipients, 2017-2019.** Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure HR 57: Patient survival among adult heart transplant recipients, 2017-2019. Patient survival estimated using unadjusted Kaplan-Meier methods.

**Patient survival among adult heart transplant recipients, 2017-2019, by age.** Patient survival estimated using unadjusted Kaplan-Meier methods. Age is recipient age at transplant.

Figure HR 58: Patient survival among adult heart transplant recipients, 2017-2019, by age. Patient survival estimated using unadjusted Kaplan-Meier methods. Age is recipient age at transplant.

**Patient survival among adult heart transplant recipients, 2017-2019, by race and ethnicity.** Patient survival estimated using unadjusted Kaplan-Meier methods. The Other race category is composed of Native American, Multiracial, and unreported categories.

Figure HR 59: Patient survival among adult heart transplant recipients, 2017-2019, by race and ethnicity. Patient survival estimated using unadjusted Kaplan-Meier methods. The Other race category is composed of Native American, Multiracial, and unreported categories.

**Patient survival among adult heart transplant recipients, 2017-2019, by diagnosis group.** Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure HR 60: Patient survival among adult heart transplant recipients, 2017-2019, by diagnosis group. Patient survival estimated using unadjusted Kaplan-Meier methods.

**Patient survival among adult heart transplant recipients, 2017-2019, by sex.** Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure HR 61: Patient survival among adult heart transplant recipients, 2017-2019, by sex. Patient survival estimated using unadjusted Kaplan-Meier methods.

**Patient survival among adult heart transplant recipients, 2017-2019, by VAD status.** Patient survival estimated using unadjusted Kaplan-Meier methods. VAD status at time of transplant. VAD, ventricular assist device.

Figure HR 62: Patient survival among adult heart transplant recipients, 2017-2019, by VAD status. Patient survival estimated using unadjusted Kaplan-Meier methods. VAD status at time of transplant. VAD, ventricular assist device.

**Patient survival among adult heart transplant recipients, 2017-2019, by former medical urgency.** Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure HR 63: Patient survival among adult heart transplant recipients, 2017-2019, by former medical urgency. Patient survival estimated using unadjusted Kaplan-Meier methods.

**Patient survival among adult heart transplant recipients, 2021-2022, by current medical urgency.** Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure HR 64: Patient survival among adult heart transplant recipients, 2021-2022, by current medical urgency. Patient survival estimated using unadjusted Kaplan-Meier methods.

**Patient survival among adult heart transplant recipients, 2017-2019, by metropolitan versus nonmetropolitan recipient residence.** Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure HR 65: Patient survival among adult heart transplant recipients, 2017-2019, by metropolitan versus nonmetropolitan recipient residence. Patient survival estimated using unadjusted Kaplan-Meier methods.

**Patient survival among adult heart transplant recipients, 2017-2019, by multiorgan transplant type.** Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure HR 66: Patient survival among adult heart transplant recipients, 2017-2019, by multiorgan transplant type. Patient survival estimated using unadjusted Kaplan-Meier methods.

**Patient survival among adult heart transplant recipients, 2017-2019, by cPRA.** Patient survival estimated using unadjusted Kaplan-Meier methods. Peak cPRA is used. cPRA, calculated panel-reactive antibody.

Figure HR 67: Patient survival among adult heart transplant recipients, 2017-2019, by cPRA. Patient survival estimated using unadjusted Kaplan-Meier methods. Peak cPRA is used. cPRA, calculated panel-reactive antibody.

**Incidence of acute rejection by 1 year posttransplant among adult heart transplant recipients by age.** Only the first reported rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier method. Age is recipient age at transplant.

Figure HR 68: Incidence of acute rejection by 1 year posttransplant among adult heart transplant recipients by age. Only the first reported rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier method. Age is recipient age at transplant.

**Incidence of PTLD among adult heart transplant recipients by recipient EBV status at transplant, 2013-2019.** Cumulative incidence is estimated using the Kaplan-Meier method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin's disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus; PTLD, posttransplant lymphoproliferative disorder.

Figure HR 69: Incidence of PTLD among adult heart transplant recipients by recipient EBV status at transplant, 2013-2019. Cumulative incidence is estimated using the Kaplan-Meier method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin’s disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus; PTLD, posttransplant lymphoproliferative disorder.

Figure HR 70: Overall deceased heart donor count. Count of deceased donors whose hearts were recovered for transplant.

Figure HR 71: Deceased heart donor count by age. Count of deceased donors whose hearts were recovered for transplant.

Figure HR 72: Distribution of deceased heart donors by age. Deceased donors whose hearts were recovered for transplant.

Figure HR 73: Distribution of deceased heart donors by sex. Deceased donors whose hearts were recovered for transplant.

**Distribution of deceased heart donors by race and ethnicity.** Deceased donors whose hearts were recovered for transplant. The Other race category is composed of Native American, Multiracial, and unreported categories.

Figure HR 74: Distribution of deceased heart donors by race and ethnicity. Deceased donors whose hearts were recovered for transplant. The Other race category is composed of Native American, Multiracial, and unreported categories.

**Distribution of deceased heart donors by donor HCV status.** Deceased donors whose hearts were recovered for transplant. Donor HCV status was based on NAT and antibody tests. Ab, antibody; HCV, hepatitis C virus; NAT, nucleic acid test.

Figure HR 75: Distribution of deceased heart donors by donor HCV status. Deceased donors whose hearts were recovered for transplant. Donor HCV status was based on NAT and antibody tests. Ab, antibody; HCV, hepatitis C virus; NAT, nucleic acid test.

**Distribution of deceased heart donors by DBD and DCD status.** Deceased donors whose hearts were recovered for transplant. DBD, donation after brain death; DCD, donation after circulatory death.

Figure HR 76: Distribution of deceased heart donors by DBD and DCD status. Deceased donors whose hearts were recovered for transplant. DBD, donation after brain death; DCD, donation after circulatory death.

Figure HR 77: Cause of death among deceased heart donors. Deceased donors with a heart recovered for transplant. CVA, cerebrovascular accident.

**Overall percentages of hearts recovered for transplant and not transplanted.** Percentages of hearts not transplanted out of all hearts recovered for transplant.

Figure HR 78: Overall percentages of hearts recovered for transplant and not transplanted. Percentages of hearts not transplanted out of all hearts recovered for transplant.

**Percentages of hearts recovered for transplant and not transplanted by donor age.** Percentages of hearts not transplanted out of all hearts recovered for transplant.

Figure HR 79: Percentages of hearts recovered for transplant and not transplanted by donor age. Percentages of hearts not transplanted out of all hearts recovered for transplant.

**Percentages of hearts recovered for transplant and not transplanted by donor sex.** Percentages of hearts not transplanted out of all hearts recovered for transplant.

Figure HR 80: Percentages of hearts recovered for transplant and not transplanted by donor sex. Percentages of hearts not transplanted out of all hearts recovered for transplant.

**Percentages of hearts recovered for transplant and not transplanted by donor race and ethnicity.** Percentages of hearts not transplanted out of all hearts recovered for transplant. The Other race category is composed of Native American, Multiracial, and unreported categories.

Figure HR 81: Percentages of hearts recovered for transplant and not transplanted by donor race and ethnicity. Percentages of hearts not transplanted out of all hearts recovered for transplant. The Other race category is composed of Native American, Multiracial, and unreported categories.

**Percentages of hearts recovered for transplant and not transplanted by donor hypertension status.** Percentages of hearts not transplanted out of all hearts recovered for transplant.

Figure HR 82: Percentages of hearts recovered for transplant and not transplanted by donor hypertension status. Percentages of hearts not transplanted out of all hearts recovered for transplant.

**Percentages of hearts recovered for transplant and not transplanted by donor BMI.** Percentages of hearts not transplanted out of all hearts recovered for transplant. BMI, body mass index.

Figure HR 83: Percentages of hearts recovered for transplant and not transplanted by donor BMI. Percentages of hearts not transplanted out of all hearts recovered for transplant. BMI, body mass index.

**Percentages of hearts recovered for transplant and not transplanted by donor cause of death.** Percentages of hearts not transplanted out of all hearts recovered for transplant. CVA, cerebrovascular accident.

Figure HR 84: Percentages of hearts recovered for transplant and not transplanted by donor cause of death. Percentages of hearts not transplanted out of all hearts recovered for transplant. CVA, cerebrovascular accident.

**Percentages of hearts recovered for transplant and not transplanted, by donor risk of disease transmission.** Percentages of hearts not transplanted out of all hearts recovered for transplant. "Risk factors" refers to risk criteria for acute transmission of human immunodeficiency virus, hepatitis B virus, or hepatitis C virus from the US Public Health Service Guideline.

Figure HR 85: Percentages of hearts recovered for transplant and not transplanted, by donor risk of disease transmission. Percentages of hearts not transplanted out of all hearts recovered for transplant. “Risk factors” refers to risk criteria for acute transmission of human immunodeficiency virus, hepatitis B virus, or hepatitis C virus from the US Public Health Service Guideline.

**New pediatric candidates added to the heart transplant waiting list.** A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and were subsequently relisted are considered new. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure HR 86: New pediatric candidates added to the heart transplant waiting list. A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and were subsequently relisted are considered new. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

**All pediatric candidates on the heart transplant waiting list.** Pediatric candidates listed at any time during the year. Candidates listed at more than one center are counted once per listing.

Figure HR 87: All pediatric candidates on the heart transplant waiting list. Pediatric candidates listed at any time during the year. Candidates listed at more than one center are counted once per listing.

**Distribution of pediatric candidates waiting for heart transplant by age.** Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included. Age is determined at the earliest of transplant, death, removal, or December 31 of the year. The 18+ category is for candidates who turned age 18 while waiting.

Figure HR 88: Distribution of pediatric candidates waiting for heart transplant by age. Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included. Age is determined at the earliest of transplant, death, removal, or December 31 of the year. The 18+ category is for candidates who turned age 18 while waiting.

**Distribution of pediatric candidates waiting for heart transplant by race and ethnicity.** Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included.

Figure HR 89: Distribution of pediatric candidates waiting for heart transplant by race and ethnicity. Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included.

**Distribution of pediatric candidates waiting for heart transplant by diagnosis.** Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included. CM, cardiomyopathy.

Figure HR 90: Distribution of pediatric candidates waiting for heart transplant by diagnosis. Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included. CM, cardiomyopathy.

**Distribution of pediatric candidates waiting for heart transplant by sex.** Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure HR 91: Distribution of pediatric candidates waiting for heart transplant by sex. Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

**Distribution of pediatric candidates waiting for heart transplant by waiting time.** Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Time on the waiting list is determined at the earliest of transplant, death, removal, or December 31 of the year. Active and inactive candidates are included.

Figure HR 92: Distribution of pediatric candidates waiting for heart transplant by waiting time. Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Time on the waiting list is determined at the earliest of transplant, death, removal, or December 31 of the year. Active and inactive candidates are included.

**Distribution of pediatric candidates waiting for heart transplant by medical urgency.** Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Medical urgency is determined at the earliest of transplant, death, removal, or December 31 of the year. Active and inactive patients are included.

Figure HR 93: Distribution of pediatric candidates waiting for heart transplant by medical urgency. Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Medical urgency is determined at the earliest of transplant, death, removal, or December 31 of the year. Active and inactive patients are included.

**Overall deceased donor heart transplant rates among pediatric waitlist candidates.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

Figure HR 94: Overall deceased donor heart transplant rates among pediatric waitlist candidates. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

**Deceased donor heart transplant rates among pediatric waitlist candidates by age.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. The 18+ category is for candidates who turned age 18 while waiting.

Figure HR 95: Deceased donor heart transplant rates among pediatric waitlist candidates by age. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. The 18+ category is for candidates who turned age 18 while waiting.

**Deceased donor heart transplant rates among pediatric waitlist candidates by race and ethnicity.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. The Other race category is composed of Native American, Multiracial, and unreported categories.

Figure HR 96: Deceased donor heart transplant rates among pediatric waitlist candidates by race and ethnicity. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately. The Other race category is composed of Native American, Multiracial, and unreported categories.

**Deceased donor heart transplant rates among pediatric waitlist candidates by metropolitan versus nonmetropolitan residence.** Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

Figure HR 97: Deceased donor heart transplant rates among pediatric waitlist candidates by metropolitan versus nonmetropolitan residence. Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting time in a given year. Individual listings are counted separately.

**Three-year outcomes for newly listed pediatric candidates waiting for heart transplant, 2019-2021.** Pediatric candidates who joined the waiting list in 2019-2021. Pediatric candidates listed at more than one center are counted once per listing. Removed from list includes all reasons except transplant and death. DD, deceased donor.

Figure HR 98: Three-year outcomes for newly listed pediatric candidates waiting for heart transplant, 2019-2021. Pediatric candidates who joined the waiting list in 2019-2021. Pediatric candidates listed at more than one center are counted once per listing. Removed from list includes all reasons except transplant and death. DD, deceased donor.

**Overall pretransplant mortality rates among pediatric candidates waitlisted for heart transplant.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

Figure HR 99: Overall pretransplant mortality rates among pediatric candidates waitlisted for heart transplant. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

**Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by age.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. The 18+ category is for candidates who turned age 18 while waiting.

Figure HR 100: Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by age. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. The 18+ category is for candidates who turned age 18 while waiting.

**Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by race and ethnicity.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. The Other race category is composed of Native American, Multiracial, and unreported categories.

Figure HR 101: Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by race and ethnicity. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. The Other race category is composed of Native American, Multiracial, and unreported categories.

**Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by diagnosis.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. CM, cardiomyopathy.

Figure HR 102: Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by diagnosis. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. CM, cardiomyopathy.

**Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by medical urgency.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Medical urgency is determined at the later of listing date or January 1 of the given year.

Figure HR 103: Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by medical urgency. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Medical urgency is determined at the later of listing date or January 1 of the given year.

**Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by metropolitan versus nonmetropolitan residence.** Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Urban/rural determination is made using the RUCA (rural-urban commuting area) designation of the candidate's permanent zip code.

Figure HR 104: Pretransplant mortality rates among pediatric candidates waitlisted for heart transplant by metropolitan versus nonmetropolitan residence. Pretransplant mortality rates are computed as the number of deaths per 100 patient-years of waiting time in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Urban/rural determination is made using the RUCA (rural-urban commuting area) designation of the candidate’s permanent zip code.

Figure HR 105: Overall pediatric heart transplants. All pediatric heart transplants, including retransplant and multiorgan.

**Pediatric heart transplants by recipient age.** All pediatric heart transplants, including retransplant and multiorgan. Age is recipient age at transplant.

Figure HR 106: Pediatric heart transplants by recipient age. All pediatric heart transplants, including retransplant and multiorgan. Age is recipient age at transplant.

Figure HR 107: Pediatric heart transplants by sex. All pediatric heart transplants, including retransplant and multiorgan.

Figure HR 108: Pediatric heart transplants by race and ethnicity. All pediatric heart transplants, including retransplant and multiorgan.

**Pediatric heart transplants by diagnosis.** All pediatric heart transplants, including retransplant and multiorgan. CM, cardiomyopathy.

Figure HR 109: Pediatric heart transplants by diagnosis. All pediatric heart transplants, including retransplant and multiorgan. CM, cardiomyopathy.

Figure HR 110: Pediatric heart transplants by medical urgency. All pediatric heart transplants, including retransplant and multiorgan.

**Pediatric heart transplants by distance between donor and center.** All pediatric heart transplants, including retransplant and multiorgan. Distance between donor and center is computed from donor hospital to the transplant center.

Figure HR 111: Pediatric heart transplants by distance between donor and center. All pediatric heart transplants, including retransplant and multiorgan. Distance between donor and center is computed from donor hospital to the transplant center.

**Pediatric heart transplants by life support device type.** All pediatric heart transplants, including retransplant and multiorgan. LVAD only means dischargeable or nondischargeable LVAD. Combination means some combination of dischargeable LVAD, nondischargeable LVAD, ECMO, IABP, and/or Impella. If none of the above, heart recipients may have used another type of life support. ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device.

Figure HR 112: Pediatric heart transplants by life support device type. All pediatric heart transplants, including retransplant and multiorgan. LVAD only means dischargeable or nondischargeable LVAD. Combination means some combination of dischargeable LVAD, nondischargeable LVAD, ECMO, IABP, and/or Impella. If none of the above, heart recipients may have used another type of life support. ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device.

**Pediatric heart transplants by number of life support treatments.** All pediatric heart transplants, including retransplant and multiorgan. Use of the following life support treatments was assessed: dischargeable LVAD, nondischargeable LVAD, dischargeable RVAD, nondischargeable RVAD, ECMO, IABP, Impella, percutaneous device, total artificial heart, prostaglandin, inhaled nitric oxide, inotropes, and ventilator. None means transplant recipient did not receive any of these treatments. Single means transplant recipient received one type of these treatments, but not any other types. Multiple means transplant recipient received at least two types of these treatments. ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device; RVAD, right ventricular assist device.

Figure HR 113: Pediatric heart transplants by number of life support treatments. All pediatric heart transplants, including retransplant and multiorgan. Use of the following life support treatments was assessed: dischargeable LVAD, nondischargeable LVAD, dischargeable RVAD, nondischargeable RVAD, ECMO, IABP, Impella, percutaneous device, total artificial heart, prostaglandin, inhaled nitric oxide, inotropes, and ventilator. None means transplant recipient did not receive any of these treatments. Single means transplant recipient received one type of these treatments, but not any other types. Multiple means transplant recipient received at least two types of these treatments. ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device; RVAD, right ventricular assist device.

**Induction agent use in pediatric heart transplant recipients.** All pediatric heart transplants, including retransplant and multiorgan. Immunosuppression at transplant reported to the OPTN.

Figure HR 114: Induction agent use in pediatric heart transplant recipients. All pediatric heart transplants, including retransplant and multiorgan. Immunosuppression at transplant reported to the OPTN.

**Type of induction agent use in pediatric heart transplant recipients.** Immunosuppression at transplant reported to the OPTN. IL2Ab, interleukin-2 receptor antibody; TCD, T-cell depleting.

Figure HR 115: Type of induction agent use in pediatric heart transplant recipients. Immunosuppression at transplant reported to the OPTN. IL2Ab, interleukin-2 receptor antibody; TCD, T-cell depleting.

**Immunosuppression regimen use in pediatric heart transplant recipients.** All pediatric heart transplants, including retransplant and multiorgan. Immunosuppression regimen at transplant reported to the OPTN. MMF, all mycophenolate agents; Tac, tacrolimus.

Figure HR 116: Immunosuppression regimen use in pediatric heart transplant recipients. All pediatric heart transplants, including retransplant and multiorgan. Immunosuppression regimen at transplant reported to the OPTN. MMF, all mycophenolate agents; Tac, tacrolimus.

**Percentages of patient deaths among pediatric heart transplant recipients.** All pediatric recipients of deceased donor hearts, including multiorgan transplant recipients. Estimates are unadjusted, computed using Kaplan-Meier methods.

Figure HR 117: Percentages of patient deaths among pediatric heart transplant recipients. All pediatric recipients of deceased donor hearts, including multiorgan transplant recipients. Estimates are unadjusted, computed using Kaplan-Meier methods.

**Overall patient survival among pediatric deceased donor heart transplant recipients, 2017-2019.** Recipient survival estimated using unadjusted Kaplan-Meier methods.

Figure HR 118: Overall patient survival among pediatric deceased donor heart transplant recipients, 2017-2019. Recipient survival estimated using unadjusted Kaplan-Meier methods.

**Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by recipient age.** Recipient survival estimated using unadjusted Kaplan-Meier methods. Age is recipient age at transplant.

Figure HR 119: Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by recipient age. Recipient survival estimated using unadjusted Kaplan-Meier methods. Age is recipient age at transplant.

**Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by race and ethnicity.** Recipient survival estimated using unadjusted Kaplan-Meier methods. The Other race category is composed of Native American, Multiracial, and unreported categories.

Figure HR 120: Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by race and ethnicity. Recipient survival estimated using unadjusted Kaplan-Meier methods. The Other race category is composed of Native American, Multiracial, and unreported categories.

**Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by diagnosis.** Recipient survival estimated using unadjusted Kaplan-Meier methods.

Figure HR 121: Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by diagnosis. Recipient survival estimated using unadjusted Kaplan-Meier methods.

**Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by medical urgency.** Recipient survival estimated using unadjusted Kaplan-Meier methods.

Figure HR 122: Patient survival among pediatric deceased donor heart transplant recipients, 2017-2019, by medical urgency. Recipient survival estimated using unadjusted Kaplan-Meier methods.

**Incidence of acute rejection by 1 year posttransplant among pediatric heart transplant recipients by age.** Only the first reported rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier method. Age is recipient age at transplant.

Figure HR 123: Incidence of acute rejection by 1 year posttransplant among pediatric heart transplant recipients by age. Only the first reported rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier method. Age is recipient age at transplant.

**Incidence of PTLD among pediatric heart transplant recipients by recipient EBV status at transplant, 2013-2019.** Cumulative incidence is estimated using the Kaplan-Meier method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or on the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin's disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus; PTLD, posttransplant lymphoproliferative disorder.

Figure HR 124: Incidence of PTLD among pediatric heart transplant recipients by recipient EBV status at transplant, 2013-2019. Cumulative incidence is estimated using the Kaplan-Meier method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or on the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin’s disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus; PTLD, posttransplant lymphoproliferative disorder.

Characteristic	2014 N	2014 Percent	2024 N	2024 Percent
Age (years)
18-34 years	367	10.0	304	9.9
35-49	834	22.7	691	22.5
50-64	1,789	48.7	1,527	49.7
65+	684	18.6	549	17.9
Sex
Female	841	22.9	632	20.6
Male	2,833	77.1	2,439	79.4
Race and ethnicity
Asian	101	2.7	104	3.4
Black	931	25.3	917	29.9
Hispanic	273	7.4	341	11.1
Multiracial	12	0.3	18	0.6
Native American	15	0.4	18	0.6
White	2,342	63.7	1,639	53.4
Unreported	0	0	34	1.1
Geography
Metropolitan	3,090	84.1	2,598	84.6
Nonmetropolitan	552	15.0	430	14.0
Missing	32	0.9	43	1.4
Distance between candidate and center (miles)
<50 miles	2,199	59.9	1,792	58.4
50-<100	599	16.3	540	17.6
100-<150	338	9.2	280	9.1
150-<250	304	8.3	244	7.9
250+	207	5.6	179	5.8
Missing	27	0.7	36	1.2
All candidates
All candidates	3,674	100.0	3,071	100.0
OPTN/SRTR 2024 Annual Data Report

Characteristic	2014 N	2014 Percent	2024 N	2024 Percent
Diagnosis
Coronary artery disease	1,240	33.8	862	28.1
Cardiomyopathy	2,095	57.0	1,797	58.5
Congenital disease	147	4.0	195	6.3
Valvular disease	35	1.0	29	0.9
Other/unknown	157	4.3	188	6.1
Blood type
A	1,138	31.0	822	26.8
AB	93	2.5	53	1.7
B	423	11.5	324	10.6
O	2,020	55.0	1,872	61.0
VAD status at listing
No VAD	2,566	69.8	1,858	60.5
VAD	1,101	30.0	1,209	39.4
Missing	7	0.2	4	0.1
Urgency status for heart candidates
Status 1A	381	10.4	0	0
Status 1B	1,592	43.3	0	0
Status 2	912	24.8	0	0
Adult status 1	0	0	24	0.8
Adult status 2	0	0	215	7.0
Adult status 3	0	0	156	5.1
Adult status 4	0	0	1,492	48.6
Adult status 5	0	0	148	4.8
Adult status 6	0	0	532	17.3
Temporarily inactive	789	21.5	504	16.4
All candidates
All candidates	3,674	100.0	3,071	100.0
OPTN/SRTR 2024 Annual Data Report

Characteristic	2014 N	2014 Percent	2024 N	2024 Percent
Previous transplant
No prior transplant	3,564	97.0	2,975	96.9
Prior transplant	110	3.0	96	3.1
Waiting time
<90 days	673	18.3	704	22.9
3-<6 months	535	14.6	414	13.5
6-<12 months	778	21.2	557	18.1
1-<2 years	792	21.6	610	19.9
2+ years	896	24.4	786	25.6
All candidates
All candidates	3,674	100.0	3,071	100.0
OPTN/SRTR 2024 Annual Data Report

OPTN Region	2023 N	2023 Percent	2024 N	2024 Percent
Region 1
Adult status 1	32	7.2	55	12.1
Adult status 2	130	29.3	133	29.2
Region 2
Adult status 1	56	7.9	97	14.0
Adult status 2	221	31.2	210	30.3
Region 3
Adult status 1	90	8.7	133	12.2
Adult status 2	350	33.9	374	34.4
Region 4
Adult status 1	42	5.4	48	5.8
Adult status 2	219	28.1	267	32.1
Region 5
Adult status 1	104	8.8	89	7.5
Adult status 2	365	31.0	373	31.2
Region 6
Adult status 1	16	8.0	21	10.2
Adult status 2	52	26.0	57	27.8
Region 7
Adult status 1	51	7.2	54	7.8
Adult status 2	229	32.4	228	33.0
Region 8
Adult status 1	19	4.8	35	8.9
Adult status 2	164	41.7	150	38.1
Region 9
Adult status 1	51	7.3	78	10.3
Adult status 2	231	33.1	227	30.0
Region 10
Adult status 1	47	6.7	51	6.7
Adult status 2	147	21.0	162	21.3
Region 11
Adult status 1	114	10.3	102	8.9
Adult status 2	332	30.1	363	31.7
OPTN/SRTR 2024 Annual Data Report

Waiting list state	2022	2023	2024
Patients at start of year	3,073	2,879	2,861
Patients added during year	4,446	5,062	5,352
Patients removed during year	4,640	5,080	5,142
Patients at end of year	2,879	2,861	3,071
OPTN/SRTR 2024 Annual Data Report

Removal reason	2022	2023	2024
Deceased donor transplant	3,652	4,068	4,125
Transplant outside US	1	0	0
Patient died	172	154	176
Patient refused transplant	20	20	30
Improved, transplant not needed	157	194	163
Too sick for transplant	212	249	221
Other	425	395	427
Still on waiting list	1	0	0
OPTN/SRTR 2024 Annual Data Report

Life support type	2021 N	2021 Percent	2024 N	2024 Percent
Any life support	2,671	79.2	3,330	80.3
Intravenous inotropes	1,344	39.8	1,753	42.3
Impella	4	0.1	1,103	26.6
Intra-aortic balloon pump	952	28.2	791	19.1
Dischargeable LVAD	750	22.2	596	14.4
Nondischargeable LVAD	38	1.1	30	0.7
Extracorporeal membrane oxygenation	234	6.9	368	8.9
Percutaneous device	205	6.1	133	3.2
Ventilator	82	2.4	89	2.1
Dischargeable RVAD	4	0.1	4	0.1
Nondischargeable RVAD	33	1.0	36	0.9
Inhaled nitric oxide	19	0.6	45	1.1
Total artificial heart	14	0.4	9	0.2
Prostaglandins	5	0.1	9	0.2
OPTN/SRTR 2024 Annual Data Report

Donor	Recipient	CMV	EBV	HBsAg	HCV antibody	HCV NAT
D-	R-	16.35	0.74	96.19	86.28	91.00
D-	R+	20.07	5.91	2.56	2.13	2.26
D-	R unk	0.55	0.13	0.87	1.00	1.07
D+	R-	24.99	7.37	0.21	10.03	5.16
D+	R+	36.05	84.09	0	0.44	0.29
D+	R unk	0.60	1.36	0	0.11	0.04
D unk	R-	0.68	0.03	0.18	0.01	0.17
D unk	R+	0.70	0.34	0	0	0.02
D unk	R unk	0.02	0.02	0	0	0
OPTN/SRTR 2024 Annual Data Report

Life support type	2019 N	2019 Percent	2024 N	2024 Percent
Any life support	380	74.7	360	73.5
Intravenous inotropes	242	47.5	186	38.0
Impella	0	0	23	4.7
Intra-aortic balloon pump	4	0.8	0	0
Dischargeable LVAD	72	14.1	40	8.2
Nondischargeable LVAD	77	15.1	107	21.8
Extracorporeal membrane oxygenation	10	2.0	23	4.7
Percutaneous device	29	5.7	31	6.3
Ventilator	55	10.8	34	6.9
Dischargeable RVAD	2	0.4	1	0.2
Nondischargeable RVAD	27	5.3	31	6.3
Inhaled nitric oxide	4	0.8	14	2.9
Total artificial heart	1	0.2	3	0.6
Prostaglandins	8	1.6	5	1.0
OPTN/SRTR 2024 Annual Data Report

Donor	Recipient	CMV	EBV
D-	R-	34.47	18.65
D-	R+	14.15	13.01
D-	R unk	1.01	1.54
D+	R-	31.19	31.12
D+	R+	16.83	33.20
D+	R unk	0.87	2.28
D unk	R-	1.07	0.13
D unk	R+	0.40	0.07
D unk	R unk	0	0
OPTN/SRTR 2024 Annual Data Report