1. The Call is Made Rhonda Duggan, BSN, RN, CCTC August 29, 2014
Living Donor Coordinator
Carolinas Medical Center

2. Kidney Matching Blood type HLA (tissue typing) Time Waiting
Medical Urgency
Antibody Level
Geographic areas/Availability

3. Liver Matching Blood Type (A,B,O, AB)
Percentage of blood groups in population:
O = 46%
A = 39%
B = 11%
AB = 4%
MELD score
Height/Weight
Wait Time considered after ABO, MELD and Height/Weight
Blood work to calculate MELD must be within 1-2 weeks
Pt’s have the option to be multi-listed at other transplant centers, transfer primary waiting time, and the option to transfer care to a different transplant center without loss of accrued waiting time.

4. Heart Matching IA-highest priority
ICU
Swan ganz catheter
One high dose inotrope or two lower dose inotropes
Mechanical circulatory support/ Mechanical ventilation
30 days after VAD implant and device related complications
None of the above, but life expectancy <7days
These hospitalized patients will be seen daily by the heart transplant service

5. Heart Matching IB
Continuous low dose inotropic support (home or hospitalized)
As an outpatient, these patients will have office visits at least every month and lab work to include PT/INR (when applicable), CBC, and CMP and PRA at least every three months. II
All patients waiting at home on oral heart failure therapy
These patients will have office visits and lab at least every three months
VII
A patient who has been listed on the waiting list, but whose status is currently inactive
If the patient’s status VII is not due to the patient being too sick to transplant, then the patient will have office visits and lab work at least every six months.

6. Organ Offers
UNOS and/or the OPO notifies the transplant center of available organ
Transplant Center has one hour to review the patient(s) that the organ is being offered for and whether to accept or decline the offer.
If unable to reach patient within 1 hour, we will move to next patient on the list
Transplant Center should have all phone numbers
Questions for patient at time of organ offer
Insurance (must match the insurance we received approval through)
Recent illness, fevers, infections, etc.
Most recent meal

7. Pre-op Surgical Work-up
Admission to hospital room on transplant unit
Labs (includes final crossmatch for kidney patients)
Chest x-ray
EKG
Evaluation by Nurse & Physicians
Shower with antimicrobial soap
Dialysis (if needed for kidney patient)
Other tests or procedures (if needed)

8. Liver Transplant Surgical Time: 6-12 hours
May be placed on bypass during surgery
Allows blood to flow through body while bypassing the liver
Blood products will
be administered during
surgery

9. Kidney Transplant Surgical Time: 3-5 hours
Blood products may be administered during surgery
Foley catheter is inserted and remains for 3-4 days
Ureteral stent placed and remains for several weeks
Induction medication infused via central venous catheter

10. Questions?