Addressing Medically Urgent Candidates in New Kidney Allocation Policy
Sponsoring Committee: Kidney Transplantation
Strategic Goal: Provide equity in access to transplants
Read the proposal (PDF; 01/2020)
View the Board Briefing Paper (PDF; 6/2020)
View the policy notice (PDF; 6/2020)
Contact: Tina Rhoades
At a glance
What is current policy and why change it?
Currently, if a physician determines that a kidney candidate’s condition is serious enough that they need a transplant immediately, they have the option to request approval from all other transplant hospitals in the same Donation Service Area (DSA) to give the candidate priority over others when a kidney is available. In December 2019, the OPTN Board of Directors approved a new kidney allocation policy that will replace DSAs with a 250 nautical mile circle around each donor hospital. This means that there will no longer be a standing set of transplant hospitals to approve requests for priority due to medical urgency. To make sure that this priority is used consistently, a defined practice to award this priority is necessary.
What’s the proposal?
- Defines a medically urgent candidate.
- Unable to receive dialysis or at high risk for not being able to receive dialysis.
- The candidate receives priority when a kidney is available within a 250 nautical mile circle.
What’s the anticipated impact of this change?
- What it’s expected to do
- Replace the existing medical urgency exception policy to align with the recently approved changes to kidney allocation policy.
- Help medically urgent kidney candidates get transplanted quickly.
- Ensure candidates receiving this priority meet a consistent definition of what is considered medically urgent.
- What it won’t do
- Apply to every kidney candidate on the wait list.
Themes to consider
- Qualifying medical urgency criteria
- Supporting evidence of criteria
- Appropriate priority over other candidates
Terms you need to know
- Donation Service Area: The geographic area designated by the Centers for Medicare and Medicaid Services (CMS) that is served by one organ procurement organization (OPO), one or more transplant hospitals, and one or more donor hospitals.
- Donor hospital: The hospital where the deceased or living donor is admitted.
- Nautical mile: Equal to 1.15 miles and is directly related to latitude and longitude; used in aviation.
- Click here to search the OPTN glossary.