EMORY HEALTHCARE
Organ Placement Program Management: Renal Pancreas: Evaluation of Renal Pancreas
Donors: Procedure
Statement:
1. Activation date: 10/10/2007, Amendment 05/07/2008, Amendment 9/5/08, Title Amendment
10/7/08, Amended 1/5/09, Amended 4/6/09, Amended 5/18/09, Amended 1/27/10, Amended 4/24/13, amended
12/21/14, amended 1/6/15, amended 2/26/15
2. Affected Department: Renal Pancreas Transplant Program, Emory Organ
Placement Program
3. Policy Statement: It is the policy of the Renal Pancreas Transplant Program to
appropriately select and manage potential Renal Pancreas transplant donors and
potential Renal Pancreas transplant recipients
4. Basis: This policy is necessary for the protection of patients, physicians and
staff.
5. Administrative Responsibility: Section heads, physicians, practitioners, and
staff are responsible for compliance with this policy.
Procedure: Acceptance Criteria for Both Local and Import Offers (unless specified)
ALL 0 MISMATCH, AB BLOOD TYPE AND HEPATITIS C POSITIVE DONORS ARE TO BE
REVIEWED WITH SURGEON ON CALL.
PHS Increased Risk:
History of being in jail
or prison
Negative NAT
testing
Negative HIV,
HbsAg, HCV
serologies
Will consider for all
potential recipients
History of Active IV
Drug abuse
Negative NAT
testing
Will consider for patients
with a PRA > 80%
History of Active IV
Drug abuse
History of Risky
Behaviors per PHS
policy
Positive NAT
testing
Negative NAT
testing
Negative HIV,
HbsAg, HCV
Serologies
Positive HIV and
HCV serologies
Negative HIV,
HbsAg, HCV
Will consider for HIV and
HCV recipients
To be determined on a
case by case basis
Maximum Age:
70 years
Minimum Donor Weight:
Pediatric En Bloc:
2 for 1:
Will not consider
Donor Trauma:
Will not consider donor with bowel perforation resulting in gross contamination
Donor malignancy:
Will consider localized cancer > 10 years ago
Will consider non-melanoma skin cancers
<10 kg
10-20kg
>20
Page 1 of 3
Will not consider
Will consider
Will consider for single kidney
Organ Placement Program Management: Renal Pancreas: Evaluation of Renal Pancreas
Donors: Procedure
(cont.)
Diabetes:
Will consider donor: May need acceptable biopsy and waiver
Hypertension:
Will consider donor. May need acceptable biopsy and waiver
Terminal Creatinine:
Will not consider donor if peak is =/> 4, stable or rising
Will consider donor if peak is > 4 and falling
Biopsy Results:
Will not accept donor biopsy with greater than 15% glomerular sclerosis.
Pancreas & K/P:
Will NOT consider if donor is greater than 500 miles from Emory Transplant Center,
UNLESS offer is a 0 mismatch for intended recipient who is highly sensitized with a
PRA of >80%.
Age:
Import - Will consider if donor is 44 years of age or younger
Local - Will consider any age donor.
Increased Risk:
Import – will consider for any recipients with PRA >80% and/or severe hypoglyemic
unawareness (noted in H & P)
Local – will consider any Increased Risk donor
DCD donor:
Kidney: will consider if donor KDPI is less than 85%.
May refuse 830 if donor is DCD and KDPI is 85% and higher.
Kidney/Pancreas: Will NOT consider
Whole Pancreas: Will NOT consider
Pancreas for Islets: Will NOT consider
Cold Ischemic Time:
Will NOT consider for import offers if estimated time of arrival to ETC is >/=
30 hours- May code 835 for organ preservation.
Sequence # on match run:
The Organ Placement Coordinator will not call the surgeon on call if the first
potential recipient for an import donor is at sequence # 500 or greater on the list.
May code 830 for donor quality.
KDPI:
LOCAL offers: Organ Placement Coordinator will call the surgeon on call regardless of
KDPI %.
IMPORT offers: Organ Placement Coordinator may refuse donor 830 IF the KDPI is >/=
90%.
Back up status:
The Organ Placement Coordinator will call the surgeon on call for all local ECD
donors, regardless of ETC position on the match run.
The Organ Placement Coordinator will not call the surgeon on call for all
Standard Criteria Donors, and import ECDs if the first potential Emory recipient
is 6th on the list or lower and none of the exclusion criteria are met. The
coordinator may select “provisional yes”, then will call the surgeon if the
recipient’s position on the list advances.
Page 2 of 3
MultiOrgan recipients:
If a recipient who requires multi organs is offered a kidney only Kidney/pancreas donors will be reviewed utilizing the policy.
Liver/kidney donors may be refused 802 (multiorgan transplant required)
Heart/kidney donors may be refused 802 (multiorgan transplant required)
Lung/kidney donors may be refused 802 (multiorgan transplant required)
HLA status:
If HLA Director reviews recipient with donor and does NOT RECOMMEND
transplant, may refuse 813 (Unacceptable antigens)
Approved by Renal Transplant Leadership Group
_______________________
Thomas C. Pearson, MD, D. Phil
Chair, Renal Transplant Leadership Group
Director, Renal Transplant Program
Revised 2.26.15
Page 3 of 3