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Board broadens options for national kidney paired donation pilot

Published on: Thursday, November 18, 2010

St. Louis - The OPTN/UNOS Board of Directors, meeting Nov. 8-9, approved a proposal to broaden potential participation in the recently established national pilot program for kidney paired donation (KPD) transplantation.

The pilot program was initially approved for operation to match only two to three pairs of transplant candidates and their intended donors. All of these intended donors had meant to donate to a specific recipient before they were found to be medically incompatible with that person. (For additional resource information about the paired donation process, visit the Professional Education - Kidney Paired Donation section of the OPTN website.

Once the newly approved protocol is implemented, pairs can be matched with a "non-directed donor" - a person who chooses to be a living donor but does not come forward to help a specific patient. By including one non-directed donor and a series of other donor/candidate pairs, a chain of transplants can be performed that ends with the transplantation of a candidate who had been awaiting a deceased donor transplant. This is known as "donor chain."

The pilot program is intended to determine whether having a national base for paired donation can result in more transplants," said OPTN/UNOS President Charles Alexander, RN, M.S.N., M.B.A. The transplant community asked us to take some extra time to study whether and how to add non-directed donors and chains; A number of transplant centers and paired donation organizations have been performing chains for years with good results, and the consensus is that this option should be part of the national pilot."

In other action, the Board approved significant revisions to pancreas allocation policy to promote equitable and efficient placement of pancreas offers from deceased donors.

The pancreas is often transplanted along with a kidney from the same donor (known as simultaneous pancreas-kidney or SPK transplantation), but some candidates receive only a pancreas. To give all types of pancreas candidates an equal opportunity to receive high-quality organ offers, the match run for all pancreas offers under the new policy will combine pancreas-only and SPK candidates onto a single list. In addition, the new policy establishes minimum medical criteria relating to pancreatic function for SPK candidates to accrue waiting time priority.

The Board also approved a series of modifications to policies relating to screening of potential deceased donors for transmissible disease and the communication of test results between organ procurement organizations, transplant centers and potential recipients. The policy amendments are intended to enhance patient safety by reflecting current clinical practice, organizing content more logically for members to follow, and further defining elements for informed consent of transplant recipients.

As soon as it is available, an executive summary of all Board meeting actions will be posted to the OPTN web site. The site also contains summaries of proceedings from past OPTN/UNOS Board meetings.

The Organ Procurement and Transplantation Network (OPTN) is operated under contract with the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Transplantation by the United Network for Organ Sharing (UNOS). The OPTN brings together medical professionals, transplant recipients and donor families to develop organ transplantation policy.