Increased Prevalence of Stroke After Heart Transplant in the New Allocation System Era

This study examines the impact of the 2018 United Network for Organ Sharing (UNOS) heart transplant allocation criteria change on posttransplant stroke rates. The study included 19,512 patients from the UNOS database who received a heart transplant between October 18, 2014, and October 17, 2022, divided into precriteria change (n = 9768) and postcriteria change (n = 9744) cohorts. The primary outcome was stroke, and secondary outcomes included mortality and adverse events. The study found that the 2018 donor heart allocation criteria change is associated with a higher risk of posttransplant stroke. Posttransplant stroke increased the risk of mortality by six-fold during the early posttransplant period.