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Author Topic: Delays in Prior Living Kidney Donors Receiving Priority on the Transplant Waitin  (Read 916 times)

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Offline Clark

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http://cjasn.asnjournals.org/content/early/2016/08/31/CJN.01360216.abstract


Delays in Prior Living Kidney Donors Receiving Priority on the Transplant Waiting List
Jennifer L. Wainright*, David K. Klassen†, Anna Y. Kucheryavaya*, Darren E. Stewart*
Published online before print
CJASN September 2016 doi: 10.2215/ CJN.01360216
Correspondence: Dr. Jennifer L. Wainright, United Network for Organ Sharing Research Department, 700 4th Street North, Richmond, VA 23219. Email: jennifer.wainright@unos.org

Abstract

Background and objectives
Prior living donors (PLDs) receive very high priority on the Organ Procurement and Transplantation Network (OPTN) kidney waiting list. Program delays in adding PLDs to the waiting list, setting their status to active, and submitting requests for PLD priority can affect timely access to transplantation.

Design, setting, participants, & measurements
We used the OPTN and the Centers for Medicare and Medicaid Services data to examine timing of (1) listing relative to start of dialysis, (2) activation on the waiting list, and (3) requests for PLD priority relative to listing date. There were 210 PLDs (221 registrations) added to the OPTN kidney waiting list between January 1, 2010 and July 31, 2015.

Results
As of September 4, 2015, 167 of the 210 PLDs received deceased donor transplants, six received living donor transplants, two died, five were too sick to transplant, and 29 were still waiting. Median waiting time to deceased donor transplant for PLDs was 98 days. Only 40.7% of 221 PLD registrations (n=90) were listed before they began dialysis; 68.3% were in inactive status for <90 days, 17.6% were in inactive status for 90–365 days, 8.6% were in inactive status for 1–2 years, and 5.4% were in inactive status for >2 years. Median time of PLDs waiting in active status before receiving PLD priority was 2 days (range =0–1450); 67.4% of PLDs received PLD priority within 7 days after activation, but 15.4% waited 8–30 days, 8.1% waited 1–3 months, 4.1% waited 3–12 months, and 5.0% waited >1 year in active status for PLD priority. After receiving priority, most were transplanted quickly. Median time in active status with PLD priority before deceased donor transplant was 23 days.

Conclusions
Fewer than one half of listed PLDs were listed before starting dialysis. Most listed PLDs are immediately set to active status and receive PLD priority quickly, but a substantial number spends time in active status without PLD priority or a large amount of time in inactive status, which affects access to timely transplants.

Unrelated directed kidney donor in 2003, 57 gallon blood & platelet donor and counting!
Rep to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, & Ad Hoc Public Solicitation of Organ Donors Committees 2005-2011

Offline elephant

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Why were so many donors not listed until after starting dialysis?
Is it because of sudden kidney failure, say from an infection, injury, or a drug side-effect?






Offline donor99

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Maybe they were not ready for transplant...even prior donors need to meet criteria....maybe they needed cardiac clearance or other clearances to prove their candidacy..if they are too sick, even as prior live donors...they need to be cleared


Offline Fr Pat

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Some years back I read (sorry, I can't remember where) that a good number of "Prior Living Donors" did not receive "priority" when they needed a transplant simply because nobody remembered to list them as being Prior Living Donors, so they stayed on the wait list. It was said at that time that Prior Living Donors, if they find themselves later in need of a transplant, should ASK and make SURE that their status as prior donors has been registered.

Offline elephant

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Yes, Fr. Pat, we need to be our own advocate and advocate for others!


Offline donor99

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I only has one and he got a transplant in 1 week....he was active and ready to go...if patients are not ready (active ) they have to wait until they are active

 

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