02 Waitlist Management Flashcards
Organ Procurement and Transplantation Network (OPTN) is the National system that carries out these 2 functions…
- maintains the waiting list and allocates donor organs to individuals waiting for an organ transplant.
- Creates the policies and rules that transplant centers, OPOs and histocompatibility labs must follow.
United Network for Organ Sharing (UNOS) is…
the current government contractor who carries out the responsibilities of the OPTN.
Per OPTN policy, the multi-disciplinary team includes these 7 groups of professionals…
- Medical Physicians/Surgeons of organ specialty
- Dietitians
- Pharmacists
- Transplant Coordinators
- Social Workers
- Psychologists
- Others as indicated by organ specialty
Listing criteria is determined by…
each individual center according to the center’s selection criteria and protocols.
Candidates for transplant fall into the following 3 categories:
- Ready for listing and transplantation
- Reassess after addressing unresolved issues
- Not a candidate for listing
UNet is…
the secure computer system used to list a candidate
For each organ, allocation may be determined by…
- Organ status such as MELD/PELD for Liver
- CAS for Lung
- KDPI/EPTS/cPRA for Kidney
- Classification/Status for Heart
National organ allocation policies do not permit favoritism based on any of these 3 factors…
- political influence
- discrimination
- financial status
The UNet application Waitlist allows for…
the addition, editing, or removal of candidates from the National Transplant Candidate Waiting List
The UNet application DonorNet allows for…
adding/reviewing donors, run matches, and send organ offers to transplant hospitals with compatible candidates
The Unet application Tiedi allows for…
the management and tracking of data from the initial listing to the actual transplant, and then through the follow-up process
Organs are matched on the following 7 criteria:
- Medical Urgency (status, CAS, MELD, etc)
- Tissue Match (prospective if required)
- Blood Type
- Waiting Time
- Organ Size
- Histocompatibility matching (HLA unacceptable antigens)
- Geographic Distance
Listing documentation required by OPTN includes these 4 items…
- Patient Selection Criteria
- ABO Documentation
- Multiple Listing/Wait Time Transfer
- Status Justification
Patient selection documentation includes these 3 items…
- selection criteria is met
- evaluation complete
- SRTR data was provided
ABO documentation requires…
- Blood type and screen x2
- Verified by second person in UNet at time of listing
For Multiple Listing, transplant programs must inform the candidate during the evaluation process if…
the transplant program does not accept candidates with multiple registrations
For wait time transfer, the transplant programs must inform the candidate during the evaluation process if…
the transplant program does not allow candidates to transfer waiting time to your program.
The potential for multi-organ candidate listing occurs if…
there is other significant end-organ dysfunction
If an additional organ is required, candidate must register…
separately for each organ
In multi-organ listing vs. single-organ listing, priority is given to
Multi-organ candidates
When a candidate is placed on the wait list, a letter is sent by the transplant program within how many days?
10 business days.
When a candidate is placed on the wait list, the letter sent by the transplant program must include these 4 items:
- The accurate date of the listing
- The OPTN Contractor’s Patient Information Letter
- The Hospital’s physician/surgeon availability coverage plan (staffing plan)
- How to contact the team after normal business hours
When a candidate in NOT placed on the wait list, a letter must be sent within how many days?
10 business days.
3 best practices to maintain effective communication with the candidate, include…
- Assess the candidate’s educational needs
- Be aware of the candidate’s social support system and include them if possible
- Use caution to maintain HIPAA compliance
Per OPTN Policy, changes to the wait list must be sent…
in writing and must include the OPTN Contractor’s Patient Information Letter.
Candidates should notify the Transplant Coordinator of any changes to these 3 items…
- health insurance
- contact information
- primary care provider
CMS requires that communication regarding additions, removals, and change in status be communicated…
in writing be communicated to the local care provider
6 Specific demographic information items required on a Tiedi form includes:
- name
- race
- state
- zip code
- citizenship
- education/academic level
6 Specific medical information required on a Tiedi form includes:
- Cognitive and motor development
- Previous transplant/Mechanical support
- Prior surgeries
- History of cancer or cardiovascular disease
- Diabetes/dialysis Lab values and test results
- Cigarette use
Specific Social/Financial information required on a Tiedi form includes:
Insurance
Maintaining listing status/priority per OPTN policies requires periodic assessment of candidates while on the waitlist and includes these 7 things:
- Complete history and physical I
- Immunocompatibility (HLA) PRA and specificities
- Pertinent diagnostic studies
- Evaluation of multi-organ function
- Infectious serology and vaccinations
- Preventive and malignancy
- General consultations (dietary, psych/social, pharmacology)
If a candidate’s medical condition changes and criteria used to justify status/priority is no longer accurate, the transplant program must update the status/priority in UNET within…
24 hours of the change in medical condition.
If the candidate is temporarily unsuitable for transplant, the transplant program may classify the candidate as…
inactive (status 7) in UNET.
Candidates are removed from the wait list for the following 5 reasons:
- Too sick to transplant
- Transferred to another center
- Transplanted
- Unable to contact patient
- Patient death
When a candidate is removed from the wait list a transplant coordinator must do the following 3 things:
- Remove in UNet
- Notify in writing within 10 business days
- Other than Death or Transplant: include the reason the candidate was removed
