Kidney Allocatio

Question 1

Kidneys from donors less than 35 years old that are not shared mandatorily for 0 HLA mismatching, for renal/non-renal organ allocation, or locally for prior living organ donors will be offered first for transplant candidates who are

Answer 1

less than 18 years old at listing regardless of the number of points assigned to the candidate relative to candidates 18 years old and older, with the exception of candidates assigned 4 points for PRA levels of 80%

Question 2

kidneys from a blood type O donor are to be allocated only to blood type O candidates and kidneys from a blood type B donor are to be allocated only to blood type B candidates, with the exception

Answer 2

for 0-ABDR mismatched candidates

Question 3

Kidneys from donors at least 18 years old must be offered singly unless the donor meets at least two of the following conditions and the OPO would not otherwise use the kidneys singly:

Answer 3

 Donor greater than 60 years old
 Estimated donor creatinine clearance less than 65 ml/min based upon serum creatinine upon admission
 Rising serum creatinine (greater than 2.5 mg/dL) at time of retrieval
 History of medical disease in donor (defined as either longstanding hypertension or diabetes mellitus)
 Adverse donor kidney histology (defined as moderate to severe glomerulosclerosis (greater than 15% and less than 50%)

Question 4

Kidneys offered for double kidney allocation will be allocated, first

Answer 4

locally, then regionally, and then nationally,

Question 5

Mandatory Sharing of 0-ABDR Mismatch Kidneys
The following policies apply to allocation of any deceased expanded criteria or standard donor kidney for which there is a

Answer 5

pediatric candidate or a sensitized adult candidate (CPRA>20%) on the waiting list with a 0-ABDR (zero antigen) mismatch.

Question 6

A kidney payback is required when a kidney is shared using any of the following methods:

Answer 6

 The 0-ABDR mismatch sharing policy
 A voluntary arrangement for sharing the kidney with an organ other than a kidney from the same donor for transplantation into the same recipient
 A voluntary arrangement for sharing the kidney for a candidate

Question 7

An OPO must not accumulate more than _____ kidney payback debts (all blood groups combined) at any point in time. Debts accumulated prior to the effective date of this Policy by an OPO:

Answer 7

9

Question 8

If a transplant program accepts a liver and performs a segmental transplant, the host OPO must

Answer 8

make reasonable attempts to offer the remaining segment according to the adult deceased donor liver match run.

Question 9

If the remaining segment has not been allocated by the time the deceased donor organ procurement has started, the

Answer 9

transplant hospital must offer it to candidates registered with the transplant program, or any medically appropriate candidate on the waiting list.

Question 10

The match run will identify a donor’s liver as one with the potential to be split if the donor meets all the following criteria:

Answer 10

1. Less than 40-years old
2. On a single vasopressor or less
3. Transaminases no greater than three times