My LVAD lifeat9200rpms: Going to status 1-A on the heart transplant list

       The University of Minnesota heart transplant coordinator called today to say that I could spend the next 30 days, probably beginning tomorrow, on the U's heart transplant list in category 1-A. 

     That makes me ready, willing, and able to receive a donated heart, should one become available.

     The categories were developed by the United Network for Organ Sharing, UNOS (www.unos.org).  I am aware of the category I'm in now, 1-B, 1-A for those in greater need of a transplant, and category 7.  The latter category is for those who must travel more than four hours from their transplantation center. 

     It is usually a temporary reassignment to Category 7 for most LVAD's.  Some one who develops an infection, non-VAD related, or has a stroke, could be listed for transplant but in Category 7.  Cat. 7 is kind of a holding pattern.

    The notion of being bumped up to Category 1-A is at once scary and promising. I have been listed as a Category 1-B for transplant since last Halloween.  So far this year there have been 13 heart transplants at the U.   No guarantees, of course. None expected.

     I am, by most measurements, doing quite well with my LVAD.  My quality of life is quite good.  Every day is a gift.  I entered the transplant list as a category 1-B.  As I understand it that means that I have end stage heart failure but am being supported by a mechanical circulatory device.  

     Not all LVAD recipients are as healthy as I currently appear to be.   If an LVAD's pump fails, causes life deteriorating issues, or he/she returns to end stage heart failure despite the pump, that individual is likely to be placed in category 1-A.  That category has the top priority for an available organ donation.

     By UNOS rules, every Category 1-B listed can be temporarily placed in Category 1-A for a maximum of 30 days.  If no matching organ is available within that time, the individual reverts to Category 1-B.  I am told that most heart transplants occur while a listee is in Category 1-B.

    The categories are governed by UNOS, a private organization under contract with the federal government that manages the national organ transplant waiting list for all organs, heart, lungs, kidneys, liver, and pancreas.  

     UNOS maintains data bases and staff to determine matches of donors to recipients and an equitable distribution of available organs throughout 11 geographic regions of the United States.  Minnesota is in Region 7, along with North and South Dakota, Wisconsin and Illinois. 

     The UNOS staff is at it 24/7, 365 days a year. They match tissue compatibility by blood type, antibodies, body size/weight, and age.

     If a heart becomes available, the U of M sends a transplant team of doctors and surgeons to the place where the donor is located. That team makes an assessment of the organ as well.  Meanwhile, since I live in Fargo, I'll travel to the U of MN by air ambulance to await final word on whether a transplant is a "go".