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J Thorac Cardiovasc Surg 2006;131:925-926
© 2006 The American Association for Thoracic Surgery

Brief Communication

Deterioration and mortality among patients with United Network for Organ Sharing status 2 heart disease: Caution must be exercised in diverting organs

^a Division of Cardiothoracic Surgery, Washington University School of Medicine, St Louis, Mo.
^b Division of Cardiology, Washington University School of Medicine, St Louis, Mo.

Presented at the American Transplant Congress, Seattle, Wash, May 22, 2005.

Received for publication May 13, 2005; accepted for publication August 17, 2005.

^_* Address for reprints: Nader Moazami, MD, Washington University School of Medicine, Department of Surgery, Division of Cardiothoracic Surgery, Queeny Tower—Suite 3108, One Barnes-Jewish Hospital Plaza, St Louis, MO 63110. (Email: moazamin@msnotes.wustl.edu).

The first 20% of the full text of this article appears below.

The initial thoracic organ allocation scheme was 7-tiered, based on that used for renal allocations. The first revision, in 1989, was to a 2-tiered system. Because of its inadequacy in addressing certain patients and potential for abuse, and before widespread use of ventricular assist devices, the United Network for Organ Sharing (UNOS) in 1999 modified its thoracic organ allocation scheme from a 2-tiered to a 3-tiered system. ¹

As contemporary medical and nontransplant surgical therapy for heart failure continues to improve, the benefit of heart transplantation in patients with UNOS status 2 heart disease has come under scrutiny. Recently, UNOS proposed a modification for the heart transplant allocation scheme that increases availability of hearts to patients with status 1A and 1B heart disease (Table 1). ² This study sought to evaluate the outcome of UNOS status 2 registrants in the era of modern medical management and under the current UNOS scheme for heart transplantation.

The study cohort included all patients aged more than 18 years . . . [Full Text of this Article]

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