If your program has a candidate that needs both a heart and a lung transplant, you should register them separately on the heart, lung, and heart-lung transplant waiting lists in UNetSM. You can find this practice referenced in Policy 3.4.C – Candidate Registrations which says that transplant programs must register all multi-organ candidates on the waiting list for each required organ.
Although Policy 6 – Allocation of Hearts and Heart-Lungs doesn’t specifically stipulate how you should list candidates who need both a heart and a lung, we recommend that you follow the practice referenced in Policy 3.4.C.
Why is it necessary to register your candidate on all three lists?
By doing so, you will ensure that your heart-lung candidate will appear in all the appropriate heart, lung and heart-lung match runs. If you were to list your candidate on only one or two of the lists, you could potentially miss suitable offers, particularly in the case of hearts.
For example, if your candidate is registered in Waitlist as needing a heart and you also indicate in UNet that they need a lung, an OPO with a heart offer must also offer you the lungs from the same donor, even if your candidate’s need for those lungs is far less urgent than others on the list. On the other hand, if your candidate is listed as needing a lung, and you also indicate in UNet that they need a heart, an OPO with a lung offer must first offer the heart from the same donor to the most urgent heart candidates. They may only offer the heart from the same donor to your candidate, if the other medically urgent candidates turn it down, or in the unlikely situation that there are no medically urgent heart candidates.
How to remove a candidate from the waiting list after they receive a transplant.
- Use the removal code “transplant” to remove a candidate from the heart-lung waiting list.
- To remove the same candidate from both the heart and the lung lists, use the removal code “other” and select “received a heart-lung transplant” as the reason.
Policy reminder: You must remove the candidate within 24 hours of the transplant (Policy 3.7.14-Removal of Thoracic Organ Transplant Candidates from Thoracic Organ Waiting Lists When Transplanted or Deceased).
If you have questions about this policy, send an email to firstname.lastname@example.org. If you have questions about how to use the Waitlist application in UNet, contact UNOS Customer Service at (800) 978-4334 or email@example.com.