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Friday, March 12, 2010

Donor Matching

As we finish our first whole month of waiting on the transplant list (March 11 completes one month)..... I wanted to answer on the blog my most common asked question. "Does the heart need to come from a child?" The answer is simply, no. Gabriella can receive a heart from a larger toddler up to a small teenager. More important than the age of the heart is the size. Her new heart needs to be big enough to pump enough blood for her 43lb body, but small enough to fit into her little frame. Hearts are not dependent on age, race, gender or religion.

I thought it would be helpful to paste a little info about how UNOS matches organs here, just for educational purposes. It truly is a fascinating process... and not so much of a "list" as it is a database. The list itself is not generated until there is an actual heart available, and the list is specific to that heart. Please, read on!

Donor Matching System

All patients accepted onto a transplant hospital's waiting list are registered with the UNOS Organ Center, where a centralized computer network links all organ procurement organizations (OPOs) and transplant centers. Staffed 24 hours a day throughout the year, the Organ Center assists with the matching, transporting, and sharing of organs throughout the U.S.

Transplant centers, tissue typing laboratories, and OPOs are involved in the organ sharing process. When donor organs are identified, the procuring organization typically accesses the UNOS computerized organ matching system, enters information about the donor organs, and runs the match program. At times, when requested or when there is a need to identify perfectly matched kidney donor/recipients, the matching process is handled by Organ Center personnel at UNOS headquarters in Richmond, Virginia.

For each organ that becomes available, the computer program generates a list of potential recipients ranked according to objective criteria (i.e. blood type, tissue type, size of the organ, medical urgency of the patient, time on the waiting list, and distance between donor and recipient). Each organ has its own specific criteria. Ethnicity, gender, religion, and financial status are not part of the computer matching system.

After printing the list of potential recipients, the procurement coordinator contacts the transplant surgeon caring for the top-ranked patient (i.e. patient whose organ characteristics best match the donor organ and whose time on the waiting list, urgency status, and distance from the donor organ adhere to allocation policy) to offer the organ. Depending on various factors, such as the donor's medical history and the current health of the potential recipient, the transplant surgeon determines if the organ is suitable for the patient. If the organ is turned down, the next listed individual's transplant center is contacted, and so on, until the organ is placed.

Once the organ is accepted for a potential recipient, transportation arrangements are made for the surgical teams to come to the donor hospital and surgery is scheduled. For heart, lung, or liver transplantation, the recipient of the organ is identified prior to the organ recovery and called into the hospital where the transplant will occur to prepare for the surgery.

The recovered organs are stored in a cold organ preservation solution and transported from the donor to the recipient hospital. For heart and lung recipients, it is best to transplant the organ within six hours of organ recovery. Livers can be preserved up to 24 hours after recovery. For kidneys and typically the pancreas, laboratory tests designed to measure the compatibility between the donor organ and recipient are performed. A surgeon will not accept the organ if these tests show that the patient's immune system will reject the organ. Therefore, the recipient is usually not identified until after these organs are recovered.



1 comment:

Tasha said...

Thank you for answering those questions! Adam was just asking them this morning and based on your answers, I answered them pretty well! Hope you all are havin an awesome day.