Waiting Process

Waiting for a donor heart

The waiting period can take several days, weeks, months, or years. It is not something that one can predict. If you are from out-of-town, you will be asked to live within one hour of the hospital once you are placed on the waiting list. The transplant coordinator must be able to locate you 24 hours a day.

Determining wait list status

After a patient is evaluated and found to be a suitable transplant candidate, the patients’ medical information is sent to UNOS (United Network for Organ Sharing) for placement on the national heart transplant waiting list. A patient can be listed as 1 of 4 statuses:

  • Status 1A is reserved for the sickest patients who require transplants immediately.  These patients typically are:
    • In the intensive care unit (ICU or CVICU)
    • Possibly on an assist device or on multiple IV drugs for support
    • Younger than 6 months old
    • Have life threatening arrhythmias
  • Status 1B will typically be a patient that is:
    • A patient and on a single IV inotropic drug
    • Has growth failure (height and/or weight less than or equal to 5% on the growth chart)
  • Status 2 includes all other patients who need cardiac transplantation.
  • Status 7 are patients who are temporarily inactive on the transplant waiting list for one reason or another such as infections, unstable conditions or change of insurance pending authorizations from a new carrier. The patients do not accrue time at this status, but they do not lose the time they have accrued.

Changes in a patient’s UNOS status are made by the transplant service based on the patient’s clinical condition. If the patient’s medical condition changes, the UNOS status is reassessed and updated. Hearts are allocated to children based on blood types, body size and then to the child with the longest wait time and the highest priority status.