Friday, January 22, 2010

Progress towards a sensibly organized national kidney exchange

An important story has played out one more quite positive step in the dry prose of medical bureaucracy, in the form of a report of the Policy Oversight Committee of the Organ Procurement and Transplantation Network (OPTN) of the Health Resources and Services Administration (HRSA). (All of the reports are found here.)

The report in question is this one, OPTN/UNOS Policy Oversight Committee, Report to the Board of Directors, November 16-17, 2009, and the item in question has to do with how a pilot national kidney exchange might be organized, if it overcomes some hurdles presently standing in its way. In particular, the cumbersome review process is catching up with the progress being made in regional kidney exchanges, in which chains have become important, expecially since the introduction of Non-simultaneous kidney exchange chains .

"The Committee supports the Kidney Transplantation Committee’s proposal to include living donors and donor chains in the Kidney Paired Donation Pilot Program. (Item 3, Page 6)."

Here it is:

"3. Proposal to include non-directed living donors and donor chains in the Kidney Paired Donation Pilot Program.

Currently, the Kidney Paired Donation (KPD) Pilot Program only allows living donors with incompatible potential recipients to participate. Non-directed (or altruistic) living donors (those who are not linked to an incompatible potential recipient) have no way to enter the program. Also, candidate / donor pairs can only be matched in groups of two or three, and all donor nephrectomies in the group must occur simultaneously. This proposal would allow non-directed living donors to participate in the KPD Pilot Program and add donor chains as an option in the system. A donor chain occurs when a non-directed living donor gives a kidney to a recipient whose living donor in turn gives a kidney to another recipient and continues the chain. This proposal would allow two types of donor chains: open and closed. Closed chains start with a non-directed living donor and end with a donation to a recipient on the deceased donor waiting list. Open chains start with a non-directed living donor and end with a bridge donor who will start another segment in the open chain. In open chains, the
bridge donor nephrectomy does not occur at the same time as the other living donor nephrectomies.
Donor chains have the potential to increase the number of transplants in a KPD system.
The Committee used the scorecard to assess this policy, and the proposal received an overall score of 23.5. The proposal received average score of greater than 2.3 in every category except patient safety and oversight, geographical equity, and operational effectiveness.
The Committee unanimously supported this proposal by a vote of 9 in favor, 0 opposed, and 0 abstentions."

1 comment:

  1. Good blog post. Thanks for helping advance the cause.

    I would appreciate your helping me get the following information to people who are in need of a kidney transplant.

    I started the LKDN after my successful transplant in 2007. The LKDN informs individuals about living kidney donation and prepares them to effectively communicate their need to family members and friends. For the past 2 years, the PKD Foundation has asked me to speak about living kidney donation during their national convention. I also lead the living donation presentation for the NKF “Preparing for Transplantation” seminar. The LKDN Workshops are offered at transplant hospitals and other organizations that support individuals with kidney disease.

    The upcoming FREE Webinar, titled Having Your Donor Find You is being held on 2 different dates, Tuesday, February 2nd and then again on Monday, February 8th at 7:30 PM Central Time.

    Who should attend? This webinar is perfect for people that are in need of a kidney transplant and want to learn more about living kidney donation and how to communicate their need to friends and family. If there is someone that wants to help them spread the word about their need, we call them Advocates, ask them to sign up for the webinar too.

    If you have any questions, please do not hesitate to contact me.

    To register for one of the Webinars go to:
    http://lkdn.org/webinars.html

    Thank you.

    Harvey Mysel
    Living Kidney Donors Network
    a Not-for-Profit 501(c)3 Organization
    Office 312-473-3772
    Mobile 847-912-7059
    www.lkdn.org
    http://lkdnblog.blogspot.com
    www.twitter.com/harveymysel
    harvey@lkdn.org

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