The Heart Allocation System in the United States

The demand for transplantation continues to increase and has always been in excess of the available donor organs. The allocation system is a set of rules intended to prioritize the most severe patients with the highest waitlist mortality. These rules impact how patients are selected for listing and which bridging strategies are utilized. Furthermore, the current wait policy has been designed based on recipients who underwent transplant with a Donation after Neurological determination of death (DNDD), but there is increased use of a Donation after Circulatory Death (DCDD) recovery strategy. This session reviews the current heart allocation system and discusses expansion of the mode of donation and its potential future impacts on the heart allocation policy. Finally, an update on progress in xenotransplantation will be reviewed.