Pediatric Heart Transplantation: When Priority Doesn't Match Urgency | JACC Baran

Pediatric Heart Transplantation: When Priority Doesn't Match Urgency | JACC Baran

Pediatric heart transplantation is one of medicine's scarcest resources, where every allocation decision can mean the difference between life and death. But does the current system truly prioritize the children at greatest risk? Hosts Mitsuaki Sawano, MD, and Satoshi Shoji, MD welcome Kazunari Sasaki, MD (Stanford University) to discuss his JACC study, Status Exceptions and Misalignment of Medical Urgency in U.S. Pediatric Heart Transplantation. Using the national OPTN registry of more than 6,000 children awaiting heart transplantation, the study examines whether "status exceptions"—special requests to elevate transplant priority—accurately reflect medical urgency and whether the National Heart Review Board has improved the fairness of organ allocation. The episode explores why well-intentioned exception requests may unintentionally disadvantage the sickest children, how waiting-list mortality varies dramatically within the highest priority category, and why objective measures of medical urgency may be needed to improve equity in donor heart allocation. Dr. Sasaki also shares insights into the evolution of the U.S. transplant system, emerging innovations such as ex vivo heart perfusion, and how data-driven policy can shape the future of pediatric transplantation.

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Episoder(93)

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

Is immune checkpoint inhibitor (ICI)-associated myocarditis the same disease when it occurs early versus months after starting cancer therapy? Host Mitsuaki Sawano, MD, and co-host Shun Kohsaka, MD, w...

3 Nov 34min

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

Is immune checkpoint inhibitor (ICI)-associated myocarditis the same disease when it occurs early versus months after starting cancer therapy? Host Mitsuaki Sawano, MD, and co-host Shun Kohsaka, MD, w...

3 Nov 34min

Does PFA Reach the Vein of Marshall? | JACC Baran

Does PFA Reach the Vein of Marshall? | JACC Baran

Does pulsed field ablation (PFA) for pulmonary vein isolation affect structures beyond the pulmonary veins? Host Mitsuaki Sawano, MD, welcomes Yosuke Nakatani, MD (Gunma University) to discuss his rec...

27 Okt 36min

A SELUTION to Paclitaxel DCB Complications in PAD? | JACC Baran

A SELUTION to Paclitaxel DCB Complications in PAD? | JACC Baran

Could sirolimus-coated balloons change how we treat femoropopliteal peripheral artery disease? Host Mitsuaki Sawano, MD, welcomes Yoshimitsu Soga, MD, PhD (Kokura Memorial Hospital) to discuss the 3-y...

20 Okt 28min

Proteomics in Action: Finding the Right Drug Targets for Ischemic Heart Disease | JACC Baran

Proteomics in Action: Finding the Right Drug Targets for Ischemic Heart Disease | JACC Baran

Which of the thousands of biomarkers associated with cardiovascular disease could actually become a useful drug target? Host Mitsuaki Sawano, MD, and co-host Nobuhiro Ikemura, MD, welcome Satoshi Yosh...

13 Okt 35min

PET Unmasks CMD: The Hidden Risk Behind Normal Perfusion | JACC Baran

PET Unmasks CMD: The Hidden Risk Behind Normal Perfusion | JACC Baran

Hosts Mitsuaki Sawano, MD, Satoshi Shoji, MD, and Kentaro Ejiri, MD, welcome Yoshito Kadoya, MD, PhD (University of British Columbia / St. Paul’s Hospital) to discuss his JACC: Cardiovascular Imaging ...

6 Okt 36min

Rethinking Health Care at Home and Abroad: Lancet RH Western Pacific Special | JACC Baran

Rethinking Health Care at Home and Abroad: Lancet RH Western Pacific Special | JACC Baran

Host Mitsuaki Sawano, MD, welcomes Shuhei Nomura, PhD (Tohoku University), Lisa Yamasaki, MD (Harvard T.H. Chan School of Public Health), and Haruka Sakamoto, MD, PhD (St. Luke’s International Hospita...

29 Sep 39min

PFA Changes the Game and the AT Circuit | JACC Baran

PFA Changes the Game and the AT Circuit | JACC Baran

Hosts Mitsuaki Sawano, MD, and Hiroyuki Sato, MD, welcome Kazutaka Nakasone, MD (Kobe University) to discuss his JACC: Clinical Electrophysiology study on atrial tachycardia (AT) after pulsed field ab...

22 Sep 36min

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