JAMA October 2026 Development and Validation of an Adult Medical Urgency Score for US Donor Heart Allocation

A recent observational study utilized registry data from adult heart transplant candidates to create and validate the US Candidate Risk Score (US-CRS) as a replacement for the current six-status allocation framework. This new quantitative model relies on specific laboratory values and mechanical support devices to more accurately assess a patient's risk of mortality while waiting for an organ. By incorporating physiological interactions rather than relying solely on therapy types, the proposed system successfully mitigates vulnerabilities to manipulationpresent in the older method. Consequently, simulations demonstrate that implementing the US-CRS framework better prioritizes genuinely ill candidateswho face the highest risk of dying before receiving a donor heart.