Listing Management, Status, and Priority Flashcards
Includes listing requirements, labs, status, etc.
When must labs be drawn and in what timeframe for a liver patient that is Status 1A or 1B?
New labs drawn every 7 days.
The labs must be no older than 2 days.
When must labs be drawn and in what timeframe for a liver patient that is MELD 25 or greater (ages 18 or older).
New labs drawn every 7 days.
The labs must be no older than 2 days.
When must labs be drawn and in what timeframe for a liver patient that is MELD/PELD 25 or greater (less than 18 years old).
New labs drawn every 14 days.
The labs must be no older than 3 days.
When must labs be drawn and in what timeframe for a liver patient that is MELD/PELD 19 to 24?
New labs drawn every 30 days.
The labs must be no older than 7 days.
When must labs be drawn and in what timeframe for a liver patient that is MELD/PELD 11 to 18?
New labs drawn every 90 days.
The labs must be no older than 14 days.
When must labs be drawn and in what timeframe for a liver patient that is MELD/PELD 10 or less?
New labs drawn every 365 days.
The labs must be no older than 30 days.
What are the 5 priority statuses that may be assigned to liver transplant candidates?
1A (adults and peds)
1B (peds only)
MELD (12 and older)
PELD (younger than 12)
Status 7
A MELD or PELD exception can be submitted by the liver provider.
What are the qualifications for Adult Status 1A patients?
5 items
- In ICU with life expectancy <7 days
- Acute liver failure (<8 weeks)
- Hepatic Artery Thrombosis within 7 days of transplant
- Primary Graft Non-Function
- Acute decompensated Wilson’s Disease
MELD scores typically range from…
6-40
What lab values are used to calculate a MELD score?
5 items
- Sodium
- Creatinine
- Albumin
- INR
- Bilirubin
What is the criteria for a listing exception for Hepatopulmonary Syndrome?
PaO2 <60 mmHg
What is the criteria for a listing exception for Portopulmonary Syndrome?
MPAP >35 mmHg
What is needed for a listing exception for Cholangiocarcinoma?
Treatment planned based on OPTN approved protocol
What labs and factors are used to calculate a PELD score?
- Creatinine
- Albumin
- Bilirubin
- INR
- Growth
- Age (< 1 year)
CIA BAG
What are the qualifications for Pediatric Status 1A patients?
4 items
- Fulminant Liver Failure
- Primary non-function within 7 days of transplant
- Hepatic artery thrombosis within 14 days of transplant
- Acute decompensated Wilson’s disease
What are the qualifications for Pediatric Status 1B patients?
2 items
- Non-metastatic hepatoblastoma
- Metabolic diseases
- Chronic liver disease with a PELD >25, and 1 of the following:
- on a vent
- has GI bleeding requiring 10 mL/kg of blood replacement in the previous 24 hours
- dialysis
- GCS <10 in last 48 hours
Liver exceptions may be submitted for primary hyperoxaluria? What is that?
Excessive urinary excretion of oxalate, which can lead to kidney stones.
Combo liver/kidney transplant patient exceptions may be submitted for a GFR less than what?
1. 30
2. 25
3. 20
4. 15
B
Liver exceptions may be submitted for an ALT greater than or equal to what?
1. 1000
2. 1250
3. 1500
4. 2000
4
Liver exceptions may be submitted for an INR greater than or equal to what?
2.0
Liver exceptions may be submitted for a total bilirubin greater than or equal to what?
10
What does Status I indicate in an intestine transplant patient?
Transplant is required in the near future
What 3 items may cause the need for intestine transplant and a Status I listing?
- Permanent intestinal failure
- Poor venous access
- Liver dysfunction
What does Status II indicate in an intestine transplant patient?
Transplant required, but stable liver function and venous access
