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Pediatric Status 1A and 1B heart and heart-lung candidates may have expanded access to intended incompatible blood type offers

Pediatric Status 1A and 1B heart and heart-lung candidates may have expanded access to intended incompatible blood type offers

On March 16, 2023, the OPTN Executive Committee approved immediate implementation of a key portion of the recently proposed policy to expand eligibility criteria to facilitate intended incompatible blood type (ABOi) offers for status 1A and status 1B pediatric heart and heart-lung transplant candidates who are registered prior to becoming 18 years old. In this initial phase, the Organ Center can accommodate individual requests to provide ABOi access for candidates who qualify under the expanded criteria.

Since 2002, OPTN policy has allowed heart transplant programs to list very young candidates (those registered prior to turning two years old) for ABOi organ offers. The OPTN Heart Transplantation Committee recently proposed broadening eligibility criteria for any status 1A or status 1B heart or heart-lung candidate registered prior to their 18th birthday.

Public comment and feedback from regional meetings indicated broad support for the proposed policy. Immediate adoption by the Executive Committee, and having a process to address initial requests, will help ensure that there is no delay in extending access to any candidate who may now qualify.

Heart transplant programs should assess whether they have any Status 1A or 1B candidates who may qualify for an ABOi listing. If so, they need to contact the Organ Center to establish a temporary, second waiting list registration for ABOi heart or heart-lung organ offers.

The OPTN Heart Transplantation Committee will continue to review public comment regarding the remaining components of the proposed policy before submitting a final proposal to the OPTN Board of Directors at its June 2023 meeting.

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