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Organ Allocation for Local Donors and Directed Donation (2.12)

Organ Allocation for Local Donors and Directed Donation (2.12) - Policies, Clinical, UWHC Clinical, Department Specific, UW Organ and Tissue Donation

2.12



POLICY
Established Date: June 2008
Effective Date: January 2018
Title: Organ Allocation for Local Donors and
Directed Donation
Policy Number: 2.12

Electronically Approved By: Michael E. Anderson, PA-C Anthony M. D’Alessandro, M.D.
Executive Director Medical Director


Page 1 of 3
PURPOSE

The purpose of this policy is to ensure deceased donor organs are allocated in accordance with United
Network for Organ Sharing (UNOS) and regulatory requirements.

DEFINITIONS

DonorNet: A comprehensive database maintained by UNOS which allows transplant professionals to
register transplant candidates on the national waiting list, match them with donated organs, and enter vital
medical data on candidates, donors and transplant recipients.

Directed Donation: The allocation of a deceased donor organ to a specific candidate named by the
individual who authorized the donation or a family member of a first person authorization (FPA) patient.

FORMS

UW OTD Directed Donation Request Form

POLICY

Organ Allocation
A. After a patient is deemed medically suitable for organ donation by the UW OTD medical director
on-call (MOC) and consent is obtained from the legal next of kin per UW OTD policy 2.06 or via
first person authorization (FPA) per UW OTD policy 2.15, the patient will be added to DonorNet.
B. A UW OTD organ procurement coordinator (OPC) will create a UNOS identification (ID) and will
enter data about the patient that is relevant to the allocation in DonorNet.
C. The University of Wisconsin Hospital and Clinics (UWHC) Histocompatibility (HLA) Lab will
complete tissue typing analysis for each patient and will enter HLA data in the DonorNet record.
D. Allocation will begin when the minimum required information has been entered as required per
UNOS policy.
E. The OPC will generate a match run for each transplantable organ and then the OPC will contact
the UW OTD administrator on call (AOC) for approval to proceed with allocation.
F. The OPC will allocate to the appropriate transplant centers based on the match run and UNOS
policy.



POLICY
Established Date: June 2008
Effective Date: January 2018
Title: Organ Allocation for Local Donors and
Directed Donation
Policy Number: 2.12

Electronically Approved By: Michael E. Anderson, PA-C Anthony M. D’Alessandro, M.D.
Executive Director Medical Director


Page 2 of 3
1. Each organ will be electronically offered to the transplant center for potential candidates
according to the match run.
2. Each transplant center will address the organ offer per UNOS policy.
3. In extenuating circumstances, the OPC may be asked to address an organ offer on behalf
of WIUW (UNOS code for the UW Health Transplant Program).
4. Complete and accurate patient information will be provided as required per UNOS policy
and per transplant center request. This includes increased risk status of the donor or risk
factors specific to the offered organ.
5. If a transplant center requires additional HLA data prior to submitting a final organ
acceptance for a thoracic organ, the transplant center will contact the OPC and the OPC
will facilitate conversations between the transplant center and the University Hospital
HLA Lab.
G. Allocation efforts will continue until each transplantable organ is placed with a candidate, the
match run has been exhausted, or UW OTD AOC determines that placement efforts for
transplant will cease.
H. If it is determined that organ placement efforts will cease for transplant, every effort will be
made by UW OTD to place the organ for research, education, or training if consent has been
obtained.
I. The OPC will make back-up allocation offers for each organ in case the primary intended
candidate is unable to receive the organ.
J. The OPC will document the results of the allocation efforts in the UW OTD patient record.

Directed Donation
K. The individual who authorized organ donation or the family of an FPA patient may directly
donate a patient’s organ(s) to an individual who is listed or who is being evaluated as a potential
transplant candidate. This is referred to as directed donation.
L. Directed donation candidates will supersede all other candidates on the match run.
If a directed donation request is made, the OPC in collaboration with donor hospital staff will
request the individual requesting the directed donation complete a Directed Donation Request
Form. The form will be filed in the UW OTD patient record and DonorNet.
M. The OPC will collect as much information as possible about the directed donation candidate,
including name, address (city and state), the listing transplant center, date of birth, social
security number, and the name of the transplant surgeon.
N. The OPC will notify the AOC.



POLICY
Established Date: June 2008
Effective Date: January 2018
Title: Organ Allocation for Local Donors and
Directed Donation
Policy Number: 2.12

Electronically Approved By: Michael E. Anderson, PA-C Anthony M. D’Alessandro, M.D.
Executive Director Medical Director


Page 3 of 3
O. For non-WIUW directed donation candidates:
1. The OPC will contact UNOS to obtain the contact information for the individual on-call at
the directed donation candidate’s transplant center.
2. The OPC will give the transplant center access to the donor in DonorNet and will proceed
with allocation per a workflow similar to that of an import organ offer.
P. For WIUW directed donation candidates:
1. The OPC will notify the MOC about liver and kidney directed donation requests or the
organ specific transplant surgeons for pancreas, heart, and lung directed donation
requests.
2. If the MOC or transplant surgeon feels the organ is acceptable, the OPC will notify the
WIUW transplant coordinator who will then and proceed with the directed donation
request.
Q. All relevant patient information will be provided to the directed donation candidate’s transplant
center. This includes blood type and HLA data (if known).
R. If the transplant center would like to proceed with the directed donation:
1. The OPC will determine if the directed donation candidate appears on at least one match
run for at least one organ type.
2. If the directed donation candidate appears on at least one match run, the organ will be
allocated to the candidate and standard allocation efforts will continue to secure back up
candidates.
3. If the directed donation candidate does not appear on at least one match run, the
transplant center will address per UNOS policy.
S. If the transplant center will not proceed with the directed donation:
1. The OPC will document the reason in donor chart.
2. The OPC will clearly and sensitively relay the outcome to the individual that requested
the directed donation.
3. Standard organ allocation will be completed.

REFERENCES

UNOS Policies 1.4 and 2.3
UW OTD Policies 2.06 and 2.15