Organ Allocation Heather LindnerThornton RN MSN CPTC Organ

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 allocation be based on medical criteria, as opposed to social criteria (social worth or wealth).

Impact of Geography • • “Local 1 st” 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 1 st 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: 1 a and 1 b— urgent and may only live 1 week; 2— generally less sick; 7—inactive but can accrue wait time for up to 30 days

0 Mis. Match • Most optimal degree of HLA compatibility • Appear 1 st on match run (local best match) • Will not appear on DCD match run unless it is a local candidate

Actual Match Run Continued