New UNOS rules: Historical background and implications for transplantationmanagement

The algorithm for the allocation of donor hearts used by the United Network for Organ Sharing (UNOS) was changed in January 1999. The new scheme alter s the medical urgency criteria from a 2-tiered to a 3-tiered system. Blood type O and blood type B candidates are less disadvantaged and pediatric can didates are somewhat advantaged with regard to adolescent donors. The new a llocation algorithm allows an individual with life-threatening ventricular arrhythmias to be listed in the highest urgency status. Increased regulatio n will occur with the establishment of a review for the highest urgency sta tus and the establishment of regional review boards.