Monday, October 19, 2009

Kidney Exchange and Nurse Coordinators

Lots of people play critical roles in making kidney exchange a reality, and a recent article emphasizes the enormous role played by nurse coordinators: Nurses: Kidney Exchange Registries Increase Compatability, Hope:

"Nurses Make It Happen: The foundation for these exchange programs is collaboration among transplant centers and the cornerstone is the nurse coordinator at each facility. These nurses are in frequent contact and are negotiating solutions as problems occur. They coordinate schedules and shipping arrangements to get the kidneys where they are needed in the shortest possible time. “We often ship the kidney to the recipient because it can be hard for donors to travel,” Charlton says. “There are times the donor is in California and the recipient is on the East Coast. The coordination among transplant centers is a massive undertaking.”Morgievich and Charlton agree the nurses who coordinate the exchanges are the driving force that makes the whole complex machine run. Larger transplant centers are the major players because they have the expertise and resources to be innovative about approaches to exchanges. Operating room schedules have to be coordinated, and detailed logistical communication schedules are set up across miles and time zones, so that as the living donor kidneys are removed and prepared for transport across the hall or across the continent, the recipient is ready. Although the surgical procedure is similar in every case, surgeons share details about the anatomy of the organ with the receiving surgical team. "

"Morgievich notes that if anyone entered “kidney exchange” into an Internet search engine five years ago, they would have had negligible results. A Google search today produced 1.2 million results in less than a second.“This is a whole new ball game, and we’ve had to create new ways to look at sharing best practices. We’ve even had to create a language for the way it works,” she says. “When we have paired donor and recipients combined with an altruistic donor, we usually have a donor at the end of the chain. We sometimes hold that donor over or find an appropriate recipient from the wait list. That last donor in the chain is called a ‘bridge donor’ because sometimes they wait until we can organize another series of exchanges. They are the bridge to the new chain.” "

Here's the google search for kidney exchange, and here are my previous blog posts with kidney exchange as a tag.

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