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Pediatric heart allocation policy and system changes

Pediatric heart allocation policy and system changes

In June 2014, the OPTN/UNOS Board of Directors approved the following changes to improve survival for pediatric heart transplant candidates:

  • Redefine status 1A and 1B criteria in WaitlistSM, to emphasize medical urgency over waiting time in heart allocation for children.
  • Increase the qualifying isohemagglutinin titer to 1:16 or less for candidates who are one year old or older, but registered before their second birthday, and who are willing to accept ABO-incompatible heart offers.
  • Change the allocation priority of urgent candidates under one year old, and transplant candidates eligible to receive ABO-incompatible heart offers.
  • Eliminate the option to register heart candidates as in utero.

We will implement this project in two parts. In the first release, on March 22, 2016, we modified the pediatric heart and heart-lung 1A and 1B justification forms in WaitlistSM to reflect the new status criteria.

View a toolkit of materials to explain the changes.

We will make additional changes to Waitlist, DonorNet® and Tiedi® later in 2016 (date to be determined). During the second release:

  • We will increase the qualifying isohemagglutinin titer to 1:16 or less for candidates who are one year old or older, but registered before their second birthday, and who are willing to accept ABO-incompatible heart offers.
  • We will change the allocation priority of urgent candidates under one year old, and transplant candidates eligible to receive ABO-incompatible heart offers.
  • We will eliminate the option to register heart candidates as in utero.
  • Waitlist: we will remove outdated policy language and update reports.
  • DonorNet: we will update the match algorithm.
  • Tiedi: we will update a look-up table.
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