Abstract
The United Network of Organ Sharing (UNOS) is the Organ Procurement and Transplantation Network (OPTN) that oversees heart transplantation in the United States. In 2016, a 10-year update to the 2006 International Listing Criteria for Heart Transplantation was published by the International Society for Heart and Lung Transplantation (ISHLT). Criteria were revised to reflect advances in the management of advanced heart failure patients, incorporate evidence from interval landmark trials, and specifically address patients with congenital heart disease, restrictive or infiltrative cardiomyopathy, and chronic infectious disease. Notable updates include frailty assessment, use of mechanical circulatory support as a bridge for candidacy, prioritization of highly sensitized patients, retransplantation for severe chronic allograft vasculopathy, removal of allocation algorithms that allowed for prioritization of higher-status patients within larger geographic areas, lower suggested cutoff values for minimal estimated glomerular filtration rate, assessment of the adequacy of social support in potential transplant candidates, and the role of heart failure prognosis scores in ambulatory patients. Three sections provide guidance on patients that may be less responsive to traditional pharmacologic and device-based therapies and/or have unique challenges with respect to support prior to transplant and posttransplant management. The OPTN policy on allocation of donor hearts was most recently revised in 2018.
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Abbreviations
- AHS:
-
Adult heart status
- CMS:
-
Centers for Medicare and Medicaid Services
- DSA:
-
Donor-specific area
- OPO:
-
Organ procurement organization
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Mooney, D.M., Sabe, M. (2019). Current Listing System. In: Bogar, L., Mountis, M. (eds) Contemporary Heart Transplantation. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-33280-2_7-1
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DOI: https://doi.org/10.1007/978-3-319-33280-2_7-1
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