Transcript Organ Allocation

Organ Allocation
Heather Lindner-Thornton
RN, MSN, CPTC
Organ Procurement Coordinator
Background Information…
• Organ allocation in the US is governed by
federal law and regulation under the US
DHHS
• OPOs have exclusive, defined service areas
• Central to these requirements is the
stipulation that that allocation be based on
medical criteria, as opposed to social
criteria (social worth or wealth).
Impact of Geography
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“Local 1st” philosophy
Local—typically the DSA of the OPO
Regional—midwest
National—U.S.
Objectives of Equitable Organ
Allocation
• Maximize the number of organs available for
transplantation
• Maximize patient and organ survival, including
maximizing the number of life-years gained
• Minimize the number of deaths while waiting for a
transplant
• Minimize disparities in the opportunity to receive
a transplant among similarly situated transplant
candidates
UNet
• A secure internet-based transplant
information database
• Created by UNOS for organ transplant
centers and OPOs
• Register patients for transplants, match
donated organs to transplant patients, and
manage the critical data of all patients
• Computer network is accessible 24/7.
UNET Screen Shot
How much information do we
need?
Attaching Information
Match Run List
Allocation
• Time accumulated on National Transplant
Waiting List
• ABO compatibility
• Geography
• Size
• Age
• HLA/PRA
• BMI
Actual Match Run
Why doesn’t the 1st patient always
get transplanted?
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He/she must be available
Healthy enough to undergo major surgery
Willing to receive transplant immediately
Further lab testing required…x-match
Status Code
• Assigned to pts awaiting transplant
• Corresponds with medical urgency (need)
for transplant
• One’s you may have heard: 1a and 1b—
urgent and may only live 1 week; 2—
generally less sick; 7—inactive but can
accrue wait time for up to 30 days
0 MisMatch
• Most optimal degree of HLA compatibility
• Appear 1st on match run (local  best match)
• Will not appear on DCD match run unless it is
a local candidate
Actual Match Run Continued