Implementation of a physician assistant-led recovery model for heart transplantation: Clinical outcomes and programmatic benefits at a high-volume center

Physician assistant (PA)-led donor recovery models have been shown to be safe and effective in lung transplantation, but data on their application in heart transplantation (HT) are limited. We conducted an observational cohort study at a high-volume heart transplant center to compare outcomes of adult HTs between 2020 and 2024 using allografts recovered by PA-led vs non-PA-led recovery teams. A total of 497 adult HTs were included: 130 in the PA group and 367 in the non-PA group. The incidence of severe primary graft dysfunction was not significantly different (7.7% vs 5.2%; P = .28). Thirty-day survival was 96.9% in the PA group and 96.3% in the non-PA group (P = .99). Implementation of a PA-led recovery model reduced attending surgeon presence in donor runs by 62.4% (P = .054) and reduced attending surgeon time commitment from 57.5 to 10.8 h/mo (P = .045). Following implementation, the number of HTs for high sequence number recipients (>50) increased at a rate of approximately 0.89 transplants per month (P = .04), compared to a prior rate of 0.03/mo. In this single-center study, implementation of a PA-led recovery model for heart allograft recovery showed no significant differences in early and medium-term patient outcomes following HT.