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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

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Organ Allocation

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  1. Organ Allocation Heather Lindner-Thornton RN, MSN, CPTC Organ Procurement Coordinator

  2. 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).

  3. Impact of Geography • “Local 1st” philosophy • Local—typically the DSA of the OPO • Regional—midwest • National—U.S.

  4. 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

  5. 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.

  6. UNET Screen Shot

  7. How much information do we need?

  8. Attaching Information

  9. Match Run List

  10. Allocation • Time accumulated on National Transplant Waiting List • ABO compatibility • Geography • Size • Age • HLA/PRA • BMI

  11. Actual Match Run

  12. Why doesn’t the 1st patient always get transplanted? • He/she must be available • Healthy enough to undergo major surgery • Willing to receive transplant immediately • Further lab testing required…x-match

  13. 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

  14. 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

  15. Actual Match Run Continued

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