When there is a donor heart, UNOS uses these rules to determine which patient will receive the organ. The decision is based on compatibility of blood types, similar body sizes (height and weight), the patient's level of illness, and accumulated time on the waiting list.

The wait for a heart transplant can last months or years. The role of the transplant team during this phase is to monitor the patient's medical condition for changes and provide advanced heart failure therapies aimed at bridging the patient to transplant if required. Clinic visits occur at least monthly. During these visits the transplant nurse coordinator provides the patient with education about their illness and what to expect after transplant. A dietician and social worker are also available if needed. Right heart catheterizations are done every 6 months to assess the heart pressures and heart function. The transplant cardiologist may also counsel a patient on receiving a sophisticated biventricular pacemaker or internal defibrillator device during the pre-transplant period.