Organ Procurement and Transplantation Assessing Current Policies and the Potential Impact of the DHHS Final Rule (1999) / Chapter Skim
Currently Skimming:
2 Current Policies and Practices
2 Current Policies and Practices
Pages 31-38
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 31... ...
All patients accepted onto a member transplant hospital's waiting list are registered with the UNOS Organ Center, where a central~zed computer network links all organ procurement organizations and transplant centers (see Box 2-1 for definitions)
|
From page 32... ...
The computerized list of patients waiting to be matched with specific donor organs in hopes of receiving transplants. Patients are registered on the UNOS waiting list by UNOS member transplant centers, programs, or OPOs.
|
From page 33... ...
OPOs distribute organs pursuant to a sharing arrangement with the prior approval by the OPTN Board of Directors. Organs must be distributed within the sharing area on the basis of a common patient waiting list unless an appropriate alternative local unit for the area is approved by the OPTN.
|
From page 34... ...
The procuring organization accesses a centralized computer operated by UNOS, enters information about the donor organs into the computer, runs the match program, and coordinates the procuring and transplanting surgical teams. The computer program generates a list of potential recipients ranked according to medical and other criteria (e.g., blood type, tissue type, size of the organ, medical urgency of the patient, as well as time already spent on the waiting list, and distance between donor and recipient)
|
From page 35... ...
, the UNOS Organ Center can be used to allocate the organ first regionally, and then nationally, based on a point system set forth in UNOS policies. Listing Criteria, Patient Status Because the current liver allocation policies give weight to waiting time, some people believe that some physicians list patients for transplants as early as possible, perhaps long before they are ready for transplant.
|
From page 36... ...
UNOS revised the listing criteria recently to address some of these issues, and some people argue that these changes, combined with advances in transplantation medicine and the OPTN's extensive investment in patient information systems, have resulted in substantial improvements in standardizing the medical urgency classifications of patients. Potential organ recipients may be placed on the waiting lists of more than one transplant center (IJNOS, 1999~.
|
From page 37... ...
Most recently, in June 1999, UNOS announced a revision to its liver allocation policy Nat aims to broaden access for the most urgent patients (UNOS, 1999~. Under the revised policy, livers will be offered first to the most urgent category of patients (status 1)
|
From page 38... ...
CONCLUSIONS The discrepancy between the number of donated organs and the need for organ transplants has called into question current policies and practices regarding allocation and distribution of organs, particularly livers. There is ongoing controversy about the uniformity of listing criteria, referral practices, donation rates, access, and the effects of these factors on waiting times.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.