TABLE 1.
Change in heart allocation criteria resulting in a new 6-tiered system
| Old allocation system | New allocation system | Listing criteria |
|---|---|---|
| Status 1 | • VA-ECMO | |
| • Nondischargeable, surgically implanted, nonendovascular biventricular support device | ||
| • MCSD with life-treatening ventricular arrhythmia | ||
| Status 1A | Status 2 | • IABP |
| • Nondischargeable, surgically implanted, nonendovascular LVAD | ||
| • VT or VF without mechanical support | ||
| • MCSD with device malfunction or failure | ||
| • TAH, BiVAD, RVAD, or VAD for single ventricle patients | ||
| • Percutaneous endovascular MCSD | ||
| Status 3 | • Dischargeable LVAD for discretionary 30 d | |
| • Multiple inotropes or single high-dose inotrope with continuous hemodynamic monitoring | ||
| • Single inotrope with continuous monitoring | ||
| • VA-ECMO after 7 d; IABP or percutaneous endovascular circulatory support device after 14 d | ||
| • Nondischargeable, surgically implanted, nonendovascular LVAD after 14 d | ||
| • Mechanical support device with complication | ||
| Status 1B | Status 4 | • Dischargeable LVAD without discretionary 30 d |
| • Inotropes without hemodynamic monitoring | ||
| • Retransplant | ||
| • Diagnosis of CHD, ischemic heart disease with intractable angina, hypertrophic CM, restrictive CM, amyloidosis | ||
| Status 2 | Status 5 | • On waitlist for at least one other organ at the same hospital |
| Status 6 | • All other active candidates |
The new adult heart allocation criteria and its corresponding status from the previous criteria for medical urgency status is adopted from the OPTN website and policies, of which full details can be found at https://optn.transplant.hrsa.gov/media/1200/optn_policies.pdf.
CHD, congenital heart disease; CM, cardiomyopathy; ECMO, venoarterial extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; (R/L) VAD, (right/left) ventricular assist device; TAH, total artificial heart; VA-MCSD, mechanical circulatory support device; VF, ventricular fibrillation; VT, ventricular tachycardia.