Impact of the United Network for Organ Sharing allocation criteria changes on temporary mechanical circulatory support use as a bridge to transplant

Table 1 Mechanical circulatory support and transplant status over the years

1989-1998, status	1999-2018, status	2018-present, status	Criteria
1	1A	1	VA-ECMO1
			Non-dischargeable surgically implanted BiVAD
			MCSD with life threatening ventricular arrythmias
		2	Non-dischargeable surgically implanted LVAD
			TAH, BiVAD, RVAD
			Malfunctioning MCSD
			Percutaneously inserted MCSD1
			IABP1
			VT/VF
		3	Dischargeable LVAD (during 30-day discretionary period)
			Multiple inotropes or single high dose inotrope with hemodynamic monitoring1
			MCSD with either hemolysis, thrombosis, right heart failure, mucosal bleeding or aortic insufficiency
			VA-ECMO after 7 days
			Non-dischargeable surgically implanted LVAD after 14 days
			Percutaneously inserted MCSD after 14 days
			IABP after 14 days
	1B	4	Dischargeable LVAD (without 30-day discretionary period)
			Inotropes (without hemodynamic monitoring)
			Congenital heart disease
			Ischemic heart disease with intractable angina
			Amyloidosis/Hypertrophic/Restrictive cardiomyopathy
			Heart re-transplant
2	2	5	Dual organ transplant candidates on waitlist
		6	All other candidates

¹Indicates that patients will also need to meet invasive and non-invasive hemodynamic criteria for cardiogenic shock to be listed under this status. VA-ECMO: Veno-arterial extracorporeal membrane oxygenation; BiVAD: Bi-ventricular assist device; MCSD: Mechanical circulatory support device; LVAD: Left ventricular assist device; RVAD: Right ventricular assist device; TAH: Total artificial heart; IABP: Intra-aortic balloon pump; VT: Ventricular tachycardia; VF: Ventricular fibrillation.