When Priority Comes Before Review: New Questions About…

When Priority Comes Before Review: New Questions About Fairness in Heart Transplant Allocation A new study published in Circulation: Heart Failure has raised important concerns about how donor hearts are allocated in the United States, revealing that many heart transplant candidates receive transplants before their requests for higher-priority status are formally reviewed. Researchers analyzed more than 11,500 adult heart transplant candidates who applied for status exceptions between 2018 and 2025. Status exceptions allow transplant centers to request elevated waitlist priority for patients who may not meet standard criteria but are believed to have comparable medical urgency. The findings are striking. More than one in four patients (26.1%) received a heart transplant before their exception request was even received by the regional review board responsible for evaluating it. Among patients whose requests w