This is the repository for all analyses performed for the study entitled "High Rate of Transplantation Prior to Review of Status Exception Requests among Adult Heart Transplant Candidates", in which we show that more than 25% of all candidates who have submitted applications for status exceptions from October 18th, 2018 to December 31, 2023 obtained heart transplants before the applications were even received by the regional review boards. There is only one file within this repository entitled "retrospective_exceptions.RMD". To run the code, the 2024 Q1 SAF, heart status justification files, and heart match run data are needed from the Scientific Registry of Transplant Recipients. A preprint using the 2024Q1 data is available on medRxiv at this URL: https://www.medrxiv.org/content/10.1101/2025.09.12.25335606v1

UPDATE (September 19, 2025): We have since obtained updated data from the SRTR as of June 30, 2025, and we have performed an updated analysis with this data. The new analysis is available in the file called "retrospective_exceptions_2025_data.RMD."

Note: The crux of this paper relies on the fact that the status justification files have a variable called "FormReceiptDt," which describes the date at which the regional review boards received a status justification file for review. By subtracting the "FormEffectiveDt," which is when a form was submitted by a transplant center and active from the "FormReceiptDt," we can determine how long it took for every status justification file to be received by the regional review boards. The data do not have a variable indicating when a status justification file was actually reviewed and voted upon by the boards.