Fiona McCurdie 4 th SATS Controversies Meeting May

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 CBMH - private recipients from W Cape, E Cape, N Cape  GSH / RXH - state recipients from W Cape, E Cape, N Cape (Paed – KZN) - private recipients from W Cape, E Cape, N Cape  TBH - state recipients from W Cape 3

 To achieve the best result in terms of graft and patient and graft outcome  Produce a fair and equitable sharing of the scarce resource  User friendly 4

 ABO matching  HLA match  PRA  Donor of <12yrs - kidneys allocated to paediatric recipient (<14yrs) 5

 1 st Kidney - donor / harvesting team  2 nd Kidney – pool kidney Allocated by following criteria - ABO Grp (never O to A, B, AB) - Length of time waiting - HLA matching - PRA - Paediatric to paediatric 6

 Ist Kidney –patient from the region supplying the kidneys  2 nd Kidney – harvesting team/ W Cape choice then - another patient from supplier region then - patient from general pool 7

 Date of tissue typing defines length of time on waiting list  Allocating person is from original “donor team”  Pool kidney allocated to a patient not a unit  If first pool patient is not well/ unavailable, kidney gets allocated to next pool patient on list. Not another patient from same unit 8

 Harvesting team not always from centre donor originally referred to – potential confusion/ conflict  Length of cold ischaemic time can influence allocation (E Cape / N Cape / W Cape flight availability and timing)  E Cape requesting to be part of general pool  NHBD programme only at GSH – kidneys remain at GSH  Consensus needed on definition of “paediatric” with respect to donor age, recipient age and priority status 9

 Meeting planned for 27 May - reps from all regions attending  Variety of issues – - Review of current system - Allocation options - Criteria for list - Public /Private - Increased Tissue Typing Lab involvement - Contributions vs benefit 10

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