Each organ procurement organization (OPO) must establish criteria for an acceptable deceased donor or deceased donor organ for the transplant programs in its Donation Service Area (DSA). If a host OPO rejects a
deceased donor, the OPO must offer the organs to OPOs that have more liberal acceptance criteria.
Evaluating and Screening Potential Deceased Donors:
The host OPO must perform all of the following and report the resulting information to all receiving OPOs or transplant hospitals:
- Attempt med/soc
- Reviewed deceased donors record
- complete PE and V/s
- document any info not available
Exceptions to the HIV screening requirement may be made for organs other than kidneys, when,
in the medical judgment of the host OPO and recipient transplant hospital or OPO, an extreme medical emergency warrants the transplantation of an organ that has not been tested for HIV.
All the following information is required for each potential deceased donor:
1.2.3.4.5.6.7.8.9.10.11.12.13.14.15.
- Age
- Sex
- Diagnosis (or cause of brain death)
- Blood type determination and reporting as outlined in Policy 2.6 above, including sub-typing for blood type A donors
- FDA licensed anti-HIV-1 and anti-HIV-2 serological testing as outlined in Policy 2.7 above
- Hepatitis serological testing; including hepatitis B surface antigen, hepatitis B core antibody, and Anti-HCV
- Venereal disease research laboratory (VDRL) or rapid plasma regain (RPR) testing. (FDA-approved diagnostic tests are acceptable.)
- Anti-cytomegalovirus (CMV) assay
- Epstein-barr virus (EBV) serological testing
- Arterial blood gas results
- Blood and urine cultures
- Chest x-ray
- Complete blood count (CBC)
- Electrolytes
- Serum glucose
- Urinalysis within 24 hours prior to cross clamp
With each kidney offer, the host OPO should provide the recipient transplant hospital with the following biopsy information for all Expanded Criteria Donor (ECD) kidneys, and for all other kidneys at the request of the accepting surgeon:
1.
2.
3.
- Wedge biopsy with the sample measuring approximately 10 mm (length) by 5 mm (width) and 5 mm (depth)
- A sample that captures a minimum of 25 glomeruli
- A frozen or fixed section slide, or the biopsy material, may accompany the kidney.
To ensure organ procurement quality, the host OPO must do all of the following:
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- Ensure that the deceased donor receives medications at appropriate times
- Document in the deceased donor record any medications administered
- Begin tissue typing and crossmatching as soon as possible
- Use standard surgical techniques in a sterile environment
- Maintain flush solutions, additives, and preservation media at appropriate temperatures
- Document in the deceased donor record, flush solutions and additives with lot numbers, along with organ anatomy, organ flush characteristics, flush solution amount, flush solution type
- Document organ abnormalities, and surgical damage, if any
Non-renal organ recovery teams have the option to
remove the non-renal organ first unless extenuating circumstances dictate otherwise.
transplant hospitals and OPOs involved must agree on the time that multiple organ procurement will begin. If the members cannot agree on the procurement time,
the host OPO may withdraw the offer from the transplant hospital or OPO unable to agree on the time for procurement to begin.
