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Policies,Administrative,UWHC,Department Specific,Transplant,Transplant - Solid Organ

Determination of Medical Urgency for Kidney Transplantation (1.23)

Determination of Medical Urgency for Kidney Transplantation (1.23) - Policies, Administrative, UWHC, Department Specific, Transplant, Transplant - Solid Organ

1.23



POLICY & PROCEDURE
Effective Date: November 2006
Revised Date: April 2014
Title: Determination of Medical Urgency for Kidney
Transplantation
Policy Number: 1.23

Page 1 of 2
I. PURPOSE

The purpose of this policy is to establish guidelines for a uniform and systematic method for
determining medical urgency for kidney transplant patients when listing patients for
transplantation; to provide patient survival with transplantation when patient is threatened by
medical conditions such as abrupt failure of transplanted kidney from technical causes.


II. POLICY

Patients that meet the following criteria will be deemed eligible for medical urgency listing.*

A. Failing Vascular Access - Patients must have undergone multiple access thrombectomies,
revisions, access placements, and are approaching exhaustion of access sites.
B. Inadequate Dialysis - Patients have life-threatening complications from dialysis or
inadequate dialysis.
C. Failed Allograft - Failure of allograft must be from a technical/ preservation/ donor issue
such as:
o Primary non-function
o Vascular thrombosis
o Vascular/ureteral injury
o Other
*0 mismatch or payback recipients will supersede patients on local medical urgency
list.

III. PROCEDURE

A. Failing Vascular Access
1. Documentation is obtained from treating nephrologist and/or access surgeon supporting
access issues.
2. Determine ECD/HCV donor suitability.
3. Review approval at weekly kidney selection meeting.
4. Placement of patient on deceased donor medical urgency list.
5. Notification is sent to all on-call transplant coordinators.
6. Notification to histocompatibility lab to crossmatch patient with all eligible appropriate
donors.
B. Inadequate Dialysis
1. Documentation is obtained from treating nephrologist supporting dialysis issues.



POLICY & PROCEDURE
Effective Date: November 2006
Revised Date: April 2014
Title: Determination of Medical Urgency for Kidney
Transplantation
Policy Number: 1.23

Page 2 of 2
2. Determine ECD/HCV donor suitability.
3. Review approval at weekly kidney selection meeting.
4. Placement of patient on deceased donor medical urgency list.
5. Notification is sent to all on-call transplant coordinators.
6. Notification to histocompatibility lab to crossmatch patient with all eligible appropriate
donors.
C. Failed Allograft
1. Patient determined to be medically suitable re-transplant candidate.
2. Re-list patient on UNOS waitlist.
3. Request wait time restoration.
4. Verify insurance coverage with transplant financial officer.
5. Determine ECD/HCV donor suitability.
6. Placement on deceased donor medical urgency list
7. Notification is sent to all on-call transplant coordinators.


IV. COORDINATION

University of Wisconsin Transplant Program


V. REVIEWED AND APPROVED BY

Transplant Service Line Policy and Procedure Committee 10/2014

VI. SIGNED BY

___ ______
Jill Ellefson, MBA Dixon Kaufman, M.D., PhD
Organ Donation and Transplant Service line Chair, UW Transplant Program