organ allocation heather lindner-thornton rn, msn, cptc organ procurement coordinator
TRANSCRIPT
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
• “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?
• 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