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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. Acceptance criteria • 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%

  15. Action: Update acceptance criteria

  16. Action: Update consents

  17. Change #4 - Sensitized candidates

  18. Highly sensitized before 0-ABDR

  19. Action: Update unacceptable antigens (UAs)

  20. Action: Review and Approve UAs

  21. Change #5 - Blood type eligibility

  22. Action: Develop clinical criteria

  23. Implementation

  24. Save the date

  25. More information Recorded webinars, podcasts, toolkits, etc. available on: OPTN web site - http://optn.transplant.hrsa.gov (click ‘Resources’ and ‘Professional Resources’) Transplant Pro* - http://transplantpro.org (click ‘I am Looking For’ and ‘Kidney Allocation System’) *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

  26. Questions? • Richard Formica, MD Committee Chair • Name Region # Representative Email • Gena Boyle Committee Liaison gena.boyle@unos.org

  27. Backup Slides

  28. KDPI

  29. 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

  30. Summary: Member responsibilities

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