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Kidney Transplantation Committee

Kidney Transplantation Committee. Spring 2014. Allocation component changes. Waiting time calculation - pre-registration dialysis time added Candidate classification - Estimated Post Transplant Survival (EPTS ) score

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Kidney Transplantation Committee

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  1. Kidney Transplantation Committee Spring 2014

  2. Allocation component changes • Waiting time calculation - pre-registration dialysis time added • Candidate classification - Estimated Post Transplant Survival (EPTS) score • Kidney donor classification - replace SCD/ECD with Kidney Donor Profile Index (KDPI) • Priority for sensitized candidates - calculated panel reactive antibody (CPRA) sliding scale

  3. Allocation component changes • Blood type eligibility - A2 and A2B to B compatible • Pediatric kidney allocation – KDPI priority • Kidney payback policy – eliminated • Kidney variances – eliminated

  4. Importance of early referral Communicate with referring physicians: • Pre-emptive listing is still advantageous • Candidates can accrue time with GFR<=20ml/ml • Priority for 0-ABDR mismatch offers

  5. Change #1 – Waiting time

  6. Change #1 – Waiting time

  7. Change #2: Candidate classification

  8. Estimated Post Transplant Survival • EPTS data variables • Age • Prior transplant • Diabetes status • Time on dialysis • EPTS score range is 0 - 100%

  9. Longevity matching

  10. Action: Review waiting time

  11. Action: Input and confirm data

  12. Action: Assess for living donors • Prior living donors get 4 points

  13. Change #3 - Kidney classification

  14. KDPI

  15. Acceptance criteria • Be mindful that other independent acceptance criteria may conflict with KDPI • Examples: • candidate opts out of DCD but selects KDPI max of 60% = will not see any DCD offers, even from KDPI 50% or less donors • candidate selects max donor age of 55 and KDPI of 60% = will not see offers from 56 y/o donor with KDPI 36%

  16. Action: Update acceptance criteria

  17. Action: Update consents

  18. Change #4 - Sensitized candidates

  19. Point changes: Sensitization CPRA Sliding Scale (Allocation Points) (CPRA<98%) 20 17.30 18 New 16 14 12.17 12 10.82 10 Points 8 Current 6.71 6 4.05 4 2.46 1.58 2 1.09 0.81 0.48 0.34 0 0 0.21 0.08 0 0 0 10 20 30 40 50 60 70 80 90 100 CPRA CPRA

  20. Highly sensitized before 0-ABDR

  21. Action: Update unacceptable antigens

  22. Action: Review and Approve UAs

  23. Change #5 - Blood type eligibility

  24. Action: Develop clinical criteria

  25. Implementation

  26. Summary: Member responsibilities

  27. Save the date

  28. More information OPTN web site - http://optn.transplant.hrsa.gov UNOS web site* -http://www.unos.org Transplant Living* -http://www.transplantliving.org Transplant Pro* - http://transplantpro.org *These are a service of United Network for Organ Sharing and are not produced under the OPTN contract. Subscribe to RSS feeds and a monthly newsletter at http://www.transplantpro.org

  29. Questions? • Richard Formica, MD • Leave a space for regional representative name and contact info – RAs will update • Gena Boyle gena.boyle@unos.org

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