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The impact of a new heart allocation policy on patient and graft survival in combined heart and kidney transplantation is unknown. A study was conducted on patients before and after the policy change and found that the new policy was associated with worse overall survival and decreased freedom from heart and kidney graft failure in recipients. Patients not on hemodialysis at the time of transplantation demonstrated worse survival and a higher risk of kidney graft failure under the new policy compared with the old policy. The new policy was associated with longer ischemic times for heart and kidney grafts and longer travel distances.
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