CardioVascular Center

Heart transplant resources

The United Network for Organ Sharing (UNOS) has announced a new system for classifying candidates on the heart transplantation waitlist will come into effect on October 18, 2018. These changes have been designed by UNOS to enable the sickest patients to have the highest priority to organs and to improve geographic access to heart transplantation in the United States. In the video below, Dr. Vest explains the new allocation system and the resources available for patients with questions. 

 

 

 

Heart transplantation status updates

Comparable Old Status  New Status Description
 1A 1
  • VA ECMO
  • Non-dischargeable surgically implanted Bi-VAD
  • LVAD with life-threatening VT or VF
 1A 2
  • Non-dischargeable surgically implanted Bi-VAD
  • Balloon pump
  • Life-threatening VT or VF
  • LVAD with mechanical failure, admitted to hospital
  • Percutaneous endovascular pump (e.g. Impella)
  • TAH, Bi-VAD, RVAD or VAD for single ventricle patient
 1A 3
  • LVAD discharged with discretionary 30 days
  • LVAD meeting criteria for device infection, hemolysis, pump thrombosis, right heart failure, mucosal bleeding or aortic regurgitation
  • Multiple inotropes/single high-dose inotrope with Swan
  • VA- ECMO, balloon pump or percutaneous endovascular pump with downgrades

 1B 2(certain diseases) 4
  • Discharges LVAD without discretionary 30 days
  • Inotropes (meeting criteria) without Swan monitoring
  • Congenital heart disease, refractory angina, re-transplantation
  • Hypertrophic cardiomyopathy, restrictive cardiomyopathy or amyloidosis meeting certain hemodynamic criteria
2 5
  • Patients listed for heart transplant and one other organ
2 6
  • All other adult heart candidates not meeting a higher status
 7 7
  • Inactive

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