transplantation

Question 1

transplant selection

Answer 1

listing (waiting list) at transplant centre after multidisciplinary assessment

Question 2

transplant allocation

Answer 2

how organs are allocated as they become available

Question 3

what does NHS blood and transplant (NHSBT) do

Answer 3

provide reliable, efficient supply of blood, organs and associated services to NHS; establish rules for organ allocation and monitors allocation (currently disconnect between waiting list and number of transplants)

Question 4

how is transplant allocation conducted

Answer 4

national guidelines, evidence based computer algorithm

Question 5

equity of transplant allocation based on evidence based computer algorithm

Answer 5

time on waiting list, super-urgent transplant (e.g. imminent death without heart, liver)

Question 6

efficiency of transplant allocation

Answer 6

best use for organs in terms of patients survival and graft survival

Question 7

what are 5 tiers of patients awaiting kidney transplant allocation dependent on

Answer 7

paediatric or adult, highly sensitised (difficult to transplant) or not

Question 8

7 elements of kidney allocation

Answer 8

waiting time, HLA match and age combined, donor-recipient age difference, location of patient relative to donor, HLA-DR homozygosity, HLA-B homozygosity, blood group match

Question 9

3 strategies to increase transplanation activity

Answer 9

deceased donation from marginal donors, living donation, future xenotransplantation/stem cell research

Question 10

2 ways deceased donation from marginal donors has been improved

Answer 10

using elderly donors who have good organs for age-matched donors, better ability at using organs from those who have died by circulatory death

Question 11

describe living donation exchange programmes

Answer 11

organ swaps for better tissue matching (large database)