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Implementation of OPTN Liver Allocation Policies (2.16)

Implementation of OPTN Liver Allocation Policies (2.16) - Policies, Clinical, UWHC Clinical, Department Specific, UW Organ and Tissue Donation

2.16




POLICY
Established Date: June 2013
Effective Date: January 2018
Title: Implementation of OPTN Liver Allocation
Policies
Policy Number: 2.16

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


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PURPOSE

A. The purpose of this policy is to define the implementation of practices for the Organ Procurement
and Transplantation Network, (OPTN) liver allocation policies. UW OTD will follow OPTN allocation
policy and UW OTD policy 2.12 and will offer liver and liver-kidney organs to transplant candidates
per the appropriate match run.


DEFINITIONS

Outside Transplant Center: Transplant center other than University of Wisconsin (UW) Transplant Program

Local Transplant Center: UW Transplant Program

POLICY

Recovery Teams
B. UW OTD has an established best practice for a self-deploying recovery team. This will provide the
most efficient process for patients being evaluated for organ recovery, patient families, donor
hospitals, and recipients.
C. When a liver is allocated to an outside transplant center, that center will provide its own recovery
team and supplies.
D. In extenuating circumstances and with UW OTD administrator on-call (AOC) and medical director
on-call (MOC) approval, the UW OTD recovery team may recover a liver on behalf of an outside
transplant center.
E. The UW OTD recovery team will interact with the patient’s family and donor hospital staff in
accordance with UW OTD policy 3.11 and workflows regardless of the presence of an outside
transplant center recovery team.

Liver-Kidney Allocation
F. When a liver is allocated to a transplant candidate from an outside transplant center and the
candidate is also listed for a kidney transplant (the kidney is noted as an additional organ on the
liver match run) UW OTD will share a kidney in addition to the liver with the candidate.




POLICY
Established Date: June 2013
Effective Date: January 2018
Title: Implementation of OPTN Liver Allocation
Policies
Policy Number: 2.16

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


Page 2 of 3

Local Back-Up
G. UW OTD will follow OPTN allocation policy and UW OTD policy 2.12 and will offer liver and liver-
kidney organs to transplant candidates per the appropriate match run.
H. UW OTD will back-up each organ offer to the subsequent transplant candidates per the appropriate
match run, OPTN policy and UW OTD policy 2.12.
I. UW OTD will not establish local back-up to an outside transplant center unless there are
extenuating circumstances approved by the AOC and MOC.
J. Upon acceptance of a liver or liver-kidney organ offer, a UW OTD organ procurement coordinator
(OPC) will proactively notify the accepting transplant center that there is no local back-up option
and will verbally confirm the intended recipient at that time. The OPC will record this conversation
in the UW OTD patient record.
K. The OPC will proactively notify the accepting transplant center that if they determine that they
cannot transplant the intended recipient they will notify the OPC on-call within 15 minutes of that
decision. The OPC will record this conversation in the patient record.
L. When an organ offer is accepted by an outside transplant center, the OPC will notify the UW
Hospital Transplant Center that an organ is intended to be exported for transplantation.
1. The purpose of this notification is to alert the UW Transplant Program because in
extenuating circumstances, the organ may not be able to be exported and may need to be
allocated to the UW Transplant Program.
2. The UW Transplant Program will determine the local transplant candidate to receive the
organ if it is not able to be exported per the appropriate match run and OPTN policy.
M. In the event that the intended recipient will not receive the organ for transplant, the OPC will notify
the UW OTD AOC for further directive.
1. The AOC will determine how to proceed to ensure the viable organ is allocated for
transplantation and the cold ischemic time for the organ is minimized.
2. The AOC may determine the best course of action is to bypass the transplant candidates
from outside transplant centers to allocate the organ to the UW Transplant Program.
3. The OPC will document this conversation in the donor record.

REFERENCES
OPTN Organ Procurement and Transplantation Network Policy
UW OTD Policies 2.12 and 3.11




POLICY
Established Date: June 2013
Effective Date: January 2018
Title: Implementation of OPTN Liver Allocation
Policies
Policy Number: 2.16

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


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