Allocation

Question 1

Lung allocation score (LAS)

Answer 1

The scoring system used to measure illness severity in the allocation of lungs to candidates 12 years and older

Question 2

Match run

Answer 2

A process that filters and ranks waiting list candidates based on deceased or non-directed living donor and candidate medical compatibility and organ-specific allocation criteria.

Question 3

Model for End Stage Liver Disease (MELD)

Answer 3

• The scoring system used to measure illness severity in the allocation of livers to adults.
• Reflects the probability of death within a 3-month period
• maximum MELD score is 40

Question 4

Antigen mismatch

Answer 4

An antigen mismatch occurs when an identified deceased or living donor antigen is not recognized as equivalent to the recipient’s own antigens. In cases where a donor or candidate only has one antigen identified at a human leukocyte antigen (HLA) locus (A, B, or DR), the antigens are considered to be identical at that locus.

Question 5

Pediatric End Stage Liver Disease (PELD)

Answer 5

• The scoring system used to measure illness severity in the allocation of livers to pediatric candidates.
• Reflects the probability of death within a 3-month period

Question 6

Potential transplant recipient (PTR)

Answer 6

A candidate who appears on a match run.

Question 7

Qualified specimen

Answer 7

A blood specimen without evidence of hemodilution

Question 8

Unacceptable antigens

Answer 8

Antigens to which the patient is sensitized and would preclude transplantation with a deceased or living donor having any one of those antigens.

Question 9

Zero antigen mismatch
zero mismatch or
0-ABDR mismatch

Answer 9

A candidate is considered a zero antigen mismatch with a deceased or living donor if all of the following conditions are met:
1. At least one donor antigen is identified for each of the A, B, and DR loci
2. At least one candidate antigen is identified for each of the A, B, and DR loci
3. The donor has zero non-equivalent A, B, or DR antigens with the candidate’s antigens
4. The donor and the candidate have compatible or permissible blood types
In cases where a candidate or donor has only one antigen identified at an HLA locus (A, B, or DR), the antigens are considered to be identical at that locus.

Question 10

Zone A

Answer 10

Includes all transplant hospitals within 500 nautical miles of the donor hospital but outside of the donor hospital’s DSA.

Question 11

Zone B

Answer 11

All transplant hospitals within 1,000 nautical miles of the donor hospital but outside of Zone A and the donor hospital’s DSA.

Question 12

Zone C

Answer 12

All transplant hospitals within 1,500 nautical miles of the donor hospital but outside of Zone B and the donor hospital’s DSA.

Question 13

Zone D

Answer 13

All transplant hospitals within 2,500 nautical miles of the donor hospital but outside of Zone C.

Question 14

Zone E

Answer 14

All transplant hospitals MORE than 2,500 nautical miles from the donor hospital.

Question 15

When can a heart be allocated out of sequence?

Answer 15

Sensitized candidates within DSA
1. The candidate’s transplant surgeon determines
the candidate’s antibodies would react adversely to certain human leukocyte antigens (HLA).
2. All heart transplant programs and the OPO within the DSA agree to allocate a heart from a compatible deceased donor to the sensitized candidate.
3. The candidate’s transplant program, all heart transplant programs, and the OPO within the DSA AGREE upon the level of sensitization at which a candidate qualifies for the sensitization exception.

Question 16

Heart- Lung Allocation Guidelines

Answer 16

• When a heart-lung candidate is allocated a HEART, the lung from the same donor MUST be allocated to the heart-lung candidate.
• When the heart-lung candidate is allocated a LUNG, the heart from the same donor may only be allocated to the heart-lung candidate if no Status 1A isolated heart candidates are eligible to receive the heart.

Question 17

Calculated Panel Reactive Antibody (CPRA)

Answer 17

percentage of donors expected to have one or more of a candidate’s indicated unacceptable antigens.

Question 18

Kidney Donor Profile Index (KDPI)

Answer 18

How Donor Kidneys are classified. The KDPI score is derived directly from the Kidney Donor Risk Index (KDRI) score. The KDPI is the percentage of donors in the reference population that have a KDRI less than or equal to this donor’s KDRI.

Question 19

Donor criteria used to calculate KDRI (10)

Answer 19

• Age
• Ethnicity
• Creatinine
• Hx of HTN
• HX of DM
• Donors with CVA COD
• Height
• Weight
• DCD Donor
• HCV status

Question 20

Blood Type O

donors allocate to

Answer 20

Universal Donor

Priority given to O

Question 21

Blood Type A

donors allocate to

Answer 21

Blood type A

Blood type AB.

Question 22

Blood Type B

donors allocate to

Answer 22

Blood type B.

Question 23

Blood Type AB

donors allocate to

Answer 23

Blood type AB.

Question 24

Blood Types A, non-A1 and AB, non-A1B

donors allocate to

Answer 24

Blood type B

Sometimes Blood type O

Question 25

What must happen before Double Kidney Allocation takes place?

Answer 25

OPO must offer kidneys individually through one of the allocation sequences before offering both kidneys to a single candidate unless donor meets Double Kidney Allocation criteria

Question 26

Double Kidney Allocation criteria (5)

Answer 26

• Age >60 yo
• Estimated creatinine clearance is less than 65 mL/min on admission
• Rising serum creatinine (greater than 2.5 mg/dL) at time of organ recovery
• Hx of longstanding htn or dm
• Glomerulosclerosis greater than 15% and less than 50%

Question 27

Choice of Right versus Left Kidney

Answer 27

the transplant hospital that received the offer for the candidate with higher priority on the waiting list will have choice

Question 28

Who Makes National Kidney Offers?

Answer 28

UNOS

Question 29

Criteria to split Liver (4)

Answer 29

1. Less than 40-years old
2. On a single vasopressor or less
3. Transaminases no greater than three times the normal level
4. Body mass index (BMI) of 28 or less

Question 30

Transplant centers have how long to review and acknowledge and offer

Answer 30

1 HOUR

Question 31

Blood type O.

Kidneys are allocated to

Answer 31

Blood type O.
For offers made to candidates in 0-ABDR mismatch categories, blood type O kidneys may be transplanted into candidates who have blood types other than O.

Question 32

Blood Type B

Kidneys are allocated to

Answer 32

Blood type B.
For offers made to candidates in 0-ABDR mismatch categories, blood type B kidneys may be transplanted into candidates who have blood types other than B.

Question 33

What transportation is the host OPO responsible for ensuring?

Answer 33

The host OPO is responsible for determining that non-local procurement teams have transportation to and from the local airport.

Question 34

Who is responsible for all transportation costs associated with deceased donor kidneys ((isolated) and tissue typing materials?

Answer 34

OPO
If deceased donor kidneys, and associated tissue typing materials are shipped without any other organs, then the host OPO is responsible for all transportation

Question 35

Who is responsible for all transportation costs associated with all non-renal organs and tissue typing materials from deceased or living donors?

Answer 35

transportation costs are the responsibility of the RECIPIENT/transplant center receiving the organ.
If an organ or tissue typing material is forwarded to another PTR for any reason the RECIPIENT/transplant center that finally receives the organ or tissue typing material is responsible for transportation costs;