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OPO Allocation Protocol Reduces Cadaveric Kidney Cold Ischemic Time

OPO Allocation Protocol Reduces Cadaveric Kidney Cold Ischemic Time. John Abrams; Lawrence Suplee; Howard M. Nathan; Richard Hasz; Sharon West  Gift of Life Donor Program, Philadelphia, PA Presented by : Lawrence Suplee. 2011 ORGAN DONATION CONGRESS.

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OPO Allocation Protocol Reduces Cadaveric Kidney Cold Ischemic Time

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  1. OPO Allocation Protocol Reduces Cadaveric Kidney Cold Ischemic Time John Abrams; Lawrence Suplee; Howard M. Nathan; Richard Hasz; Sharon West  Gift of Life Donor Program, Philadelphia, PA Presented by: Lawrence Suplee 2011 ORGAN DONATION CONGRESS

  2. Gift of Life Donor ProgramPhiladelphia, Pennsylvania USA • Non-Profit OPO/Tissue Recovery/Eye Bank • Established in 1974 • Federally designated OPO (by Medicare) for eastern PA, Southern NJ & Delaware - 130 Acute Care Hospitals • 15 Transplant Centers, 43 Programs • 10.3 Million Population • 2011* Projected Data: • - 440 Organ Donors / 42.7 Donors/MM • - 1,236 Bone Donors and 2,551 Cornea Donors • Over 31,000 organs for transplantation and over 375,000 tissue allografts • Accredited by: Association of Organ Procurement Organizations (AOPO); American Assoc. of Tissue Banks (AATB) & Eye Bank Assoc. of America (EBAA); UNOS/OPTN member OPO *Source: Gift of Life data. 2011 Projection Based on YTD performance through 11/15/2011

  3. Introduction & Purpose Transportation Give Away Final XM TXP Allocate List HLA Cold Ischemic Time Renal Distribution Time Transplant Center Time Renal Distribution Time (RDT) (OPO driven) RDT is defined as the time from cross-clamp to when a kidney is available to a center for a specific recipient including complete donor history and compatible final crossmatch. Transplant Center Time (TxT)(Center driven) TxT is defined as the time a center requires to implant the kidney from renal distribution time.

  4. HLA identification process starts using peripheral blood immediately after family consent Blood routinely sent to all local HLA Labs Improving Renal Distribution Times Specialized OPO renal allocation staff initiate kidney distribution Final crossmatches performed by all local Transplant Centers Couriers alerted and present at donor hospital to transport kidneys to accepting center

  5. Results: Renal Distribution Times (RDT)2006 to 2010

  6. ECD Median Times (Hours)2006 – 2010

  7. SCD Median Times (Hours)2006 – 2010

  8. Local SCD Kidney ATN Rates by CIT2006 – 2010

  9. Local ECD Kidney ATN Rates by CIT2006 – 2010

  10. Conclusion • OPO re-design of core process for renal allocation reduced median CIT by • SCD by 3 Hours 23% (actual time) • ECD by 1.8 Hours 14% (actual time) • OPO reduction in renal distribution time (RDT) by: • 61% (SCD) to 2 hours • 39% (ECD) to 2.8 Hours • Median TxT (from 15 centers) varied by center from 4’ 44” to 8’ 54” • Transplant centers should examine their practices after accepting a kidney to ensure lowest possible CIT • OPOs should measure RDT to improve kidney allocation

  11. QUESTIONS? Comments? For correspondence email: LSuplee@donors1.org

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