Table 2. Proposed new tiers for heart allocation model.

Proposed new tiers	Corresponding current tiers
1  i. VA ECMO	Status 1A
ii. Non-dischargeable BiVAD	Status 1A or 1B
iii. MCS with life-threatening ventricular arrhythmia	Status 1A
2  i. Non-dischargeable LVAD	Status 1A
ii. TAH, BiVAD, or RVAD	Status 1A or 1B
iii. MCS with device malfunction	Status 1A
iv. Percutaneous endovascular MCS device	Status 1A
v. IABP	Status 1A
vi. VT or VF	Status 1A
3  i. Dischargeable LVAD for discretionary 30 days	Status 1A
ii. Multiple inotropes or single inotrope with continuous hemodynamic monitoring	Status 1A
iii. MCS with hemolysis	Status 1A
iv. MCS with pump thrombosis	Status 1A
v. MCS with right heart failure	Status 1A
vi. MCS with device infection	Status 1A
vii. MCS with mucosal bleeding	Status 1A
viii. MCS with aortic insufficiency	Status 1A
ix-xi. VA ECMO, percutaneous endovascular circulatory support devices, or IABP after 14 days	Status 1A
4  i. Dischargeable LVAD without discretionary 30 days	Status 1B
ii. Inotropes without hemodynamic monitoring	Status 1B
iii. Congenital heart disease	NA
iv. Ischemic heart disease with intractable angina	NA
v. Amyloidosis, hypertrophic, or restrictive cardiomyopathy	NA
vi. Retransplant	NA
5 Combined organ transplants	NA
6 All remaining candidates	Status 2
7 Inactive/not transplantable candidates	Status 7/inactive

BiVAD, biventricular assist device; ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device; MCS, mechanical circulator support; RVAD, right ventricular assist device; TAH, total artificial heart; VA, venoarterial.

This table was adapted with permission from Meyer DM, Rogers JG, Edwards LB, et al., The future direction of the adult heart allocation system in the United States. Am J Transplant 2015;15:44-54 and https://optn.transplant.hrsa.gov/media/2028/thoracic_policynotice_201612.pdf (accessed May 24, 2017).