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Published byGinger Hodge Modified over 9 years ago
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Fiona McCurdie 4 th SATS Controversies Meeting May 2011 1
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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
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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
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ABO matching HLA match PRA Donor of <12yrs - kidneys allocated to paediatric recipient (<14yrs) 5
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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
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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
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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
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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
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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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