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Pediatric Heart Allocation System Changes Now Effective

Pediatric Heart Allocation System Changes Now Effective

Background:
OPTN/UNOS Board of Directors approved policy changes in June 2014.
We just completed the second phase of a two-part project to decrease waiting list mortality for pediatric heart transplant candidates. In March, we implemented the first phase, which revised pediatric heart status 1A and 1B justification forms in WaitlistSM to reflect the new status criteria.

We made the following changes on July 7, 2016:

  • Increased the qualifying isohemagglutinin titer to 1:16 or less for Status 1A/1B candidates who are one year old or older, but registered before their second birthday, and who are willing to accept intended blood group incompatible heart offers.
  • Added a new the treatment question “Has candidate received any treatments within the prior 30 days that may have reduced titer value to 1:16 or less?”
  • Changed the allocation priority of candidates under one year old, and candidates eligible to receive intended blood group incompatible heart offers.
  • Eliminated the option to register heart candidates as in utero.
  • Removed outdated policy language
  • Modified reports in Waitlist.

Important: Transition plan for pediatric candidates beginning July 7

For candidates who are less than one year old on July 7

  • If they have titers entered, the titer values will not be affected.
  • The response to the treatment question (“Has candidate received any treatments within the prior 30 days that may have reduced titer value to 1:4 or less?”) will not transition over to the new system.
  • The next time titer data are updated, you will have to answer the new treatment question (“Has candidate received any treatments within the prior 30 days that may have reduced titer value to 1:16 or less?”)

For candidates who are one or older on July 7, but less than two years old at the time of registration, the following actions are required for candidates to be eligible for intended blood group incompatible offers as of July 7:

  • The system will display the previously entered titer values but they will not be used.
  • Action required: Members must reenter the titer values if they have not yet expired, or enter the new titer values.
  • The response to the treatment question (“Has candidate received any treatments within the prior 30 days that may have reduced titer value to 1:4 or less?”) will not transition over to the new system.
  • Action required: Members will have to answer the new treatment question (“Has candidate received any treatments within the prior 30 days that may have reduced titer value to 1:16 or less?”)

Resources

View a toolkit of materials that explain the changes, including policy and system instructional recordings, frequently asked questions, and more. Read the policy notice for more information.

Questions?
If you have additional questions relating to policy, contact your UNOS Regional Administrator at 804-782-4800.
If you have questions relating to the system, contact UNOS Customer Service (UNet Help Desk) at 800-978-4334.

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