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Draft Organ Allocation Criteria. Factors affecting Allocation. Medical need Length of waiting time: time a illness progressed to a point when transplant would be of immediate benefit Medical urgency: more imp. In liver and heart Capacity to benefit Donor/recipient matching

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Presentation Transcript
factors affecting allocation
Factors affecting Allocation
  • Medical need
  • Length of waiting time: time a illness progressed to a point when transplant would be of immediate benefit
  • Medical urgency: more imp. In liver and heart
  • Capacity to benefit
  • Donor/recipient matching
  • Logistics e.g. availability of patient with in the reqd. time
  • Ischemic time: Time from retrieval to transplant
waiting list
WAITING LIST

The parameters to be highlighted are:

  • Blood Group
  • Duration of wait on the list
  • Criticality
criteria for organ allocation
Criteria for Organ Allocation

KIDNEY

Factors for consideration:

  • Blood Group matching---- MUST
  • Time duration since dialysis /since registration
  • Tissue type matching with Donor (HLA matching)
  • PRA (Panel Reactive Antibody) Score: if > 90% ---priority listing
  • Pediatric Patient --- less than 18 years on dialysis for more than 1 year-------priority listing
slide5
LIVER
  • Criteria for Urgent Liver Transplantation:
    • Fulminant hepatic failure: Patient on ventilator gets priority
    • Hepatic Artery Thrombosis following a liver transplant
    • Primary non-function of a graft
    • Pediatric Patients with severe metabolic disorders or hepatoblastoma

Non-urgent Patient

-waiting time

-ABO blood group matching recipient with higher MELD Score gets priority

slide6
Heart Transplant:

Criteria for Allocation:

  • ABO incompatibility except paediatric < 12 month
  • Negative lymphocytotoxic cross match
  • Size and Wt. compatibility with donor
  • Urgent Status: Patient with LVAD (LV Assisted device) followed by Pt. with Intraaorticbaloon pump
  • Waiting time
  • Logistical consideration
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