1 / 27

Living Donor Options: Paired Kidney Exchange

Living Donor Options: Paired Kidney Exchange. Karen M. Miller, RN, BSN, CCTC October 8, 2011. I have no conflict of interest nor will I be discussing any off-label use of drugs or products. Many paired kidney exchanges to choose from. New England Program for Kidney Exchange (NEPKE)

bianca-carrillo
Download Presentation

Living Donor Options: Paired Kidney Exchange

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Living Donor Options: Paired Kidney Exchange Karen M. Miller, RN, BSN, CCTC October 8, 2011

  2. I have no conflict of interest nor will I be discussing any off-label use of drugs or products

  3. Many paired kidney exchanges to choose from • New England Program for Kidney Exchange (NEPKE) • Hopkins group • Alliance for Paired Kidney Exchange • UNOS • University of Michigan Paired Kidney • North Central Donor Exchange Cooperative • MatchingDonors

  4. National Kidney Registry • Founder, wife and family (six initial donors) were incompatible with daughter • Entered every paired exchange in the United States • No matches found in paired exchange • There had to be a better solution…

  5. Its Success • 501 Non profit corporation • Started with $2,500,000 in contributions • First transplants were facilitated in 2/08 • Over 40 donor chains have been started to date • 349 transplants have been facilitated to date • 10 Month Average Wait Time for Match/Xplant • More swaps than any organization in the world

  6. Evolution of Paired Exchange Non Directed Altruistic Donor Two Pair Exchange R D D Cluster #1 D R R R D R D Three Pair Exchange R Cluster #2 D D D D R R R R D R D R Cluster #3 D Etc.

  7. How Has NKR Been Able To Facilitate So Many Paired Exchange Transplants? • Daily Match Runs Faster matching • Real-time 12 deep matching engine… Modeled after NYSE • Web portal for easy pair enrollment … Fast center startup • No personal information required … Avoids HIPAA issues • Automated match offer & tracking… Organized & efficient • Majority of top centers participating… For the greater good • Not controlled by a single center… No conflict of interest • Leveraging the power of donor chains…Open & closed clusters

  8. Match Offer Process

  9. Speed to MatchEstimates based on blood type combinations & recipient PRA

  10. Participating Center Fee Schedule • Center start-up & training $4,950/ one-time • Additional cost for non-standard NKR BAA $1,000/ one-time • Database management & technology support • 0 transplants facilitated over prior 12 months $100/ month • 1 transplant facilitated over prior 12 months $250/ month • 2 transplants facilitated over prior 12 months $500/ month • 3 transplants facilitated over prior 12 months $750/ month • Additional transplants facilitated prior 12 months $250/ xplant/month • Center annual membership $2,500/ year • Terms • No contract required • Service can be cancelled at any time without penalty

  11. Match Offer Email

  12. Match Offer Medical Information

  13. Match Offer Contacts

  14. UW Experience • Joined NKR 12/1/10 • Have completed 11 transplants, to date, successfully • Have completed 7 non directed donors (humanitarian) • 1st pair entered 12/6/10 • 16 link chain • 16 donors and 16 recipients • 1st pair completed 2/10/11 • UW donor in the OR at 3 am. • UW recipient in the OR at 2pm. • UW donor kidney to UCSF • UW recipient kidney from Pittsburgh • UW donor and recipient (creat 1.4) doing well

  15. The Process

  16. In Summary • National Kidney Registry has completed the most paired kidney transplants compared to any other paired exchange program • Excellent support • Fast paced/high energy • Have assisted UW in completing 11 more transplants. Eleven patients transplanted that, may, otherwise not have received. Two of those patients highly sensitized. • Have assisted UW in started 7 chains (with non directed donors), which has cumulated in 27, additional, transplants throughout the United States

  17. But, it takes a team to make it successful… • Tony D’Alessandro • Luis Fernandez • John Pirsch • Aji Djamali • Transplant surgeons and fellows • Chris Lillesand • Sara O’Loughlin • Elaine Synder and B4/6 staff • HLA staff especially Dave Lorentzen and Katie Meuer • OPO staff especially Mike Anderson • OR team especially Jeff Fenne and Tom Coughlin • Mike Armbrust • Jan Pankow • Kris Patterson • Billing and Fiscal, especially Mary Beth Benson • Data staff, especially Bridget Welch • Transplant Coordinators • Erinn Pullen • Rebecca Hays

More Related