The most recent change, due to go live in Oct 2016, is the introduction of the Super Urgent Heart Allocation (SUHAS) Scheme. This is for a category of patients who already meet all of the criteria for listing on the Urgent Heart Allocation (UHAS) Scheme but who in addition, are critically ill on short-term VAD’s with which they cannot be released to go home and who are not suitable for long term VAD’s. The aim of introducing this new category is to ensure that patients with the greatest need will have the highest priority for a donor heart.

The effect on the H&I does not change much as the work involved would be similar to that already being done for the UHAS. The pre-listing tests do not change nor do the regular 3 monthly antibody tests. One thing to make sure of if only one HLA antibody has been tested is to make sure a second sample, bled at least 24 hours apart is taken and tests. Once listed, in when an offer is made the carries out the immunological risk assessment to advice on the level of risk based on BST/BSHI guidelines and any locally agreed variations.

Criteria for the UHAS include:

• Patients on mechanical circulatory support devices (MCSD)
• Patients with Intra-Aortic Balloon Devices (IABD)
• Patients on Extra-Corporeal Membrane Oxygenation (ECMO)
• Patients on some muscle contraction medication (inotropes)