2025 HFSA Contemporary Issues in Heart Failure - OnDemand-Understanding UNOS, the OPTN and Allocation Changes

Video Transcription

Video Summary

Jennifer Calger from Henry Ford Hospital discusses the structure and process of heart transplant policy in the United States, focusing on the roles of the OPTN (Organ Procurement Transplant Network) and UNOS (United Network for Organ Sharing). Established under the National Organ Transplant Act of 1984 and formalized in the 2000 OPTN Final Rule, OPTN governs organ allocation policies, data management, and oversight with funding and oversight from the U.S. government via HRSA. UNOS, a nonprofit, administers the OPTN contract. Jennifer explains how policy changes, such as heart transplant status and allocation, undergo rigorous data review, public comments, and board approval before implementation, emphasizing transparency and equity. Recent initiatives include escalating transplant status for patients on LVAD support and the development of a continuous distribution system that ranks candidates by multiple factors beyond medical urgency—such as blood type, sensitization, waiting time, and pediatric priority—to improve fairness. She highlights ongoing efforts to regulate out-of-sequence organ allocation, manage the rise of DCD (donation after cardiac death) transplants, and ensure patient safety. Jennifer stresses the importance of public and professional engagement in policy feedback and encourages heart transplant professionals to stay informed and involved in OPTN policy development for advancing the U.S. transplant system.

Keywords

Heart Transplant Policy

OPTN

UNOS

Organ Allocation

LVAD Support

Continuous Distribution System

DCD Transplants