03 Deceased Donor Selection Flashcards
Within a transplant center, dDetermination of donor exclusion criteria is based upon…
- your own center’s protocols.
- Each center can set their own criteria.
The new Donor Risk Criteria applies to events that have ocurred within how many days?
30 days before organ procurment.
A Risk Criteria Donor includes someone who has had sex (i.e. any method of sexual contact, including vaginal, anal, and oral) with a person known or suspected to have…
HIV, HBV, or HCV infection.
A Risk Criteria Donor includes a man who has had sex…
with another man.
A Risk Criteria Donor includes someone who has had sex in exchange for…
money or drugs.
A Risk Criteria Donor includes someone who has had sex with a person who…
had sex in exchange for money or drugs.
A Risk Criteria Donor is someone who had drug injection for…
non-medical reasons.
A Risk Criteria Donor is someone who has had sex with a person who injected drugs for…
non-medical reasons.
A Risk Criteria Donor is someone who was incarcerated (confinement in jail, prison, or juvenile correction facility) for…
> or = 72 consecutive hours.
A Risk Criteria Donor includes a child breastfed by a mother with
HIV infection.
A Risk Criteria Donor includes a child born to a mother with
HIV, HBV, or HCV infection.
A Risk Criteria Donor includes someone with unknown…
medical or social history.
Per OPTN Policy, __________ makes the decision to accept/decline an organ
The transplant physician, not the coordinator
An offer must be acknowledged within _____ hour(s) or your patient will be bypassed.
one
If the minimum offer requirements have been met by the OPO, but you would like more information how long from the original offer time do you have to decide?
the one hour rule (from original offer time) still applies
6 Required Deceased Donor Information for all organs includes:
- Age
- Cause of Death
- Gender
- Geographic location of donor
- Blood and urine cultures
- Infectious Disease testing
6 Required Infectious Disease testing for ALL organs includes:
- HIV: NAT and antibody (anti-HIV)
- HBV: NAT, total anti-HBc, and HBsAg
- HCV: NAT and anti-HCV
- Syphilis donor screening or diagnostic test (DT)
- Cytomegalovirus (CMV) antibody (anti-CMV) donor screening or DT
- Epstein-Barr Virus (EBV) antibody (anti-EBV) donor screening or DT
8 items Required for Deceased Kidney Donors includes:
- Donor name, ID, and ethnicity
- Date of admission for the current hospitalization
- Relevant past medical or social history
- Current history of abdominal injuries, operations, or abnormalities (blood vessels, ureters, or kidney)
- Current history of avg blood pressure, hypotensive episodes, avg urine output, and oliguria
- Current medications and transfusion history Indications of sepsis
- HLA information
- Recovery information
Required HLA information for Deceased Kidney Donors includes which antigens and splits for all loci?
A, B, Bw4, Bw6, C, DR, DR51, DR52, DR53 and DQB
6 Required Recovery information for Deceased Kidney Donors includes:
- Final urinalysis
- Final blood urea nitrogen (BUN)
- Final Creatinine
- Recovery Blood Pressure and urine output
- Recovery medications, type of recovery procedure, flush solution and method, flush storage solution
- Warm ischemia time, organ flush, cold ischemia
8 Required information for Deceased Liver Donors includes:
- Donor ID, and ethnicity
- Height and weight
- Vital signs including blood pressure, heart rate, and temperature
- Social history, including drug use
- History of treatment in hospital including current medications, vasopressors, and hydration
- Current history of hypotensive episodes, urine output, and oliguria
- Indications of sepsis
- Liver specific lab values
10 Required lab values for Deceased Liver Donors includes:
- Aspartate aminotransferase (AST)
- Alanine aminotransferase (ALT)
- Alkaline phosphatase
- Bilirubin
- Creatinine
- Hemoglobin (hgb) and hematocrit (hct)
- International normalized ratio (INR)
- Prothrombin (PT)
- Partial thromboplastin time (PTT)
- White blood cell count (WBC)
11 Required information for Deceased Heart Donors includes:
- Height and Weight
- Vital signs, including blood pressure, heart rate, and temperature
- History of treatment in hospital including vasopressors and hydration
- Cardiopulmonary, social, and drug activity histories
- Details of any documented cardiac arrest or hypotensive episodes
- 12-lead interpreted electrocardiogram
- Arterial blood gas results and ventilator settings
- Troponin
- Cardiology consult or echocardiogram, if the hospital has the facilities
- Human leukocyte antigen (HLA) typing if requested by the transplant hospital, including A, B, Bw4, Bw6, C, DR, DR51, DR52, DR53, and DQB antigens
- Toxoplasma antibody (Ab) test result or an appropriate donor sample sent with the heart for testing at the transplant hospital
12 Required information for Deceased Lung Donors includes:
- Height and Weight
- Vital signs, including blood pressure, heart rate, and temperature
- History of treatment in hospital including vasopressors and hydration
- Smoking history
- Cardiopulmonary, social, and drug activity histories
- Arterial blood gases and vent settings on 5 cm/H20/PEEP including PO2/FiO2 ratio and 100% FiO2, within 2 hours prior to the offer
- Bronchoscopy results
- Chest x-ray interpreted by a radiologist or qualified physician within 3 hours prior to the offer
- Details of any documented cardiac arrest or hypotensive episodes
- Sputum gram stain, with description of sputum
- Electrocardiogram and Echocardiogram, if the OPO has the facilities
- HLA typing if requested by the transplant hospital, including A, B, Bw4, Bw6, C, DR, DR51, DR52, DR53, and DQB antigens
If the OPO cannot perform a bronchoscopy, it must…
- document that it is unable to provide results.
11 Required information for Deceased Pancreas Donors includes:
- Donor ID, and Ethnicity
- Weight
- Date of admission for the current hospitalization
- Alcohol use (if known)
- Current history of abdominal injuries and operations, pancreatic trauma
- Current history of average blood pressure, hypotensive episodes, cardiac arrest, average urine output, and oliguria
- Current medication and transfusion history
- Pertinent past medical or social history including pancreatitis
- Familial history of diabetes Insulin protocol Indications of sepsis
- Serum amylase
- HLA info: A, B, Bw4, Bw6, C, DR, DR51, DR52, DR53, and DQB antigens.
3 items of information that may be requested for specific organs, but is not required includes…
- Kidney Biopsy
- Heart Cath
- Lung Measurements/CT/ Mycology sputum smear
3 Roles of the Transplant Coordinator in the offer process includes…
- Reviews the donor with the Surgeon
- Reviews the recipient with the Surgeon
- Enters Acceptance/rejection into Unet
The Transplant Coordinator must obtain consent from the recipient for these 2 things:
- KDPI > 85%
- If the donor tests positive for any:
- Hepatitis B surface antigen (HBsAg)
- Hepatitis B nucleic acid test (NAT)
- Hepatitis C NAT
- The donor tests positive for HIV and the transplant hospital participates in an approed variance according to policy 15.7
The Transplant Coordinator documents the following 3 items of information has been communicated to the patient:
- any Donor Risk Criteria
- DCD Donor
- Research protocols
Discovery of new Donor disease or malignancy requires these 4 actions…
- Notifying the recipient of risk of transmissible disease
- Document new information in electronic health record
- Follow a recipient who is at increased risk
- Offer recipient additional testing, monitoring, and treatment in addition to routine follow up care.
