We will implement the new adult heart allocation policy tomorrow on Oct. 18, 2018. Make sure you have wrapped up all of your final data entry for your existing heart and heart-lung candidates before that takes place.
A few things to remember:
Many of you have asked questions about your patients who are currently being treated with inotropes and do not have a cardiac index measurement that meets the requirements for status 4 under the new policy. You can find the answer in the updated FAQ under Policy 6.1.D.ii: Inotropes without Hemodynamic Monitoring.
You can access heart allocation guidance and heart review board guidelines here. Also, remember that review board operations are changing. Starting Thursday, review board members will be reviewing exception requests from other regions.
Remember that policy 6.3 regarding status updates exists now and will continue to exist when the new adult heart policy takes effect on Thursday.
6.3 Status Updates
If a candidate’s medical condition changes and the criteria used to justify that candidate’s status is no longer accurate, then the candidate’s transplant program must update the candidate’s status and report the updated information to the OPTN Contractor within 24 hours of the change in medical condition.
This means that when the new justification forms take effect on October 18, you need to make sure that the criteria you selected for your candidates between Sept.18 and today still accurately represents your candidate’s medical condition. For example, if you indicated that your candidate was on VA ECMO in the last month, but if on Oct. 18 they are no longer on VA ECMO, you will need to submit a new status justification form within 24 hours.
OPOs should be aware that your match runs for hearts and heart-lungs may look different since the new policy changes the distribution of hearts to ensure that the most urgent candidates within the DSA and Zone A receive offers first.
Available resources
- Toolkit: contains policy language, FAQ, information on heart devices and candidate status, and more.
- Q&A for patients about how the policy change will affect them
- Patient information (PowerPoint presentation you can use to educate your patients about the policy change)
- All policy and system training available on UNOS Connect.
