Deceased Donor Selection

Question 1

Donor risk criteria applies to events that have occured within…
A. The last 72 hours before organ procurement
B. The last 14 days before organ procurement
C. The last 30 days before organ procurement
D. The last 90 days before organ procurement

Answer 1

C

Question 2

A Risk Criteria Donor is someone who was incarcerated for more than…
A. 24 hours
B. 48 hours
C. 72 hours
D. 1 week

Answer 2

C

incarcerated = confinement in jail, prison, juvenile correction facility

Question 3

Organ offers must be acknowledged within – hour(s) or the patient will be bypassed.
A. 1/2 hour
B. 1 hour
C. 2 hours
D. 4 hours

Answer 3

B

If you want more info about the donor, the one hour rule still applies.

Question 4

What information is required for all donor organs?

6 items

Answer 4

• Age
• Cause of Death
• Gender
• Geographic location of donor
• Blood and urine cultures
• Infectious Disease Testing (HIV, HBV, HCV, CMV, EBV, Syphilis)

Question 5

What information is required for deceased kidney donors?

8 items

Answer 5

• Donor name, ID, ethnicity
• Date of admission for current hospitalization
• Medical or social history
• History of abdominal injuries, operations, abnormalities
• History of average BP, hypotensive episodes, urine output, and oliguria
• Current medications, tranfusion history
• HLA
• Recovery info

Question 6

Required HLA information for deceased kidney donors includes…

Answer 6

A, B, Bw4, Bw6, C, DR, DR51, DR52, DR53, DQB antigens

Question 7

Required recovery information for deceased kidney donors includes…

5 items

Answer 7

• Final UA
• Final BUN and creatinine
• Recovery BP and UOP
• Recovery medications, type of recovery procedure, flush solution and method of flush
• Warm ischemia time, cold ischemia time

Question 8

What information is required for deceased liver donors?

8 items

Answer 8

• Donor name, ID, ethnicity
• Height/weight
• VS including BP, HR, and temp
• Social and medical history
• History of treatment in hospital, medications, vasopressors, hydration
• History of hypotensive episodes, urine output, oliguria
• Indications of sepsis
• Liver labs (AST, ALT, Alk Phos, Bili, Creatinine, Hgb/Hct, INR, PT, PTT, WBC)

Question 9

What information is required for deceased heart donors?

11 items - just be familiar

Answer 9

• Height and weight
• VS including BP, HR, Temp
• History of hospital treatment, including hydration and vasopressors
• Cardiopulmonary, social, and drug activity history
• History of cardiac arrest or hypotensive episodes
• 12-lead EKG
• Arterial blood gas and vent settings
• Troponin
• Cardiology consult/echocardiogram - if the hospital has the facilities
• HLA (A, B, Bw4, Bw6, C, DR, DR51, DR52, DR53, and DQB antigens)
• Toxoplasma Ab test (or a sample sent with heart for testing)

Question 10

What information is required for deceased lung donors?

Answer 10

• height and weight
• VS including BP, HR, temp
• History of hospital treatment, including hydration and vasopressors
• smoking history
• cardiopulmonary, social, and drug history
• Arterial blood gasses and vent settings - on 5 cm/H2O/PEEP including PO2/FiO2 ratio and 100% FiO2 within 2 hours prior to the offer
• Bronchoscopy results
• CXR interpreation within 3 hours prior to the offer
• History of cardiac arrest or hypotensive episodes
• Sputum gram stain and description
• EKG and Echo, if the hospital has the facilities
• HLA typing (A, B, Bw4, Bw6, C, DR, DR51, DR52, DR53, and DQB antigens)

Question 11

What information is required for deceased pancreas donors?

Answer 11

• Donor name, ID, ethnicity
• weight
• date of admission
• Alcohol use (if known)
• History of abdominal injuries, operations, pancreatic trauma
• history of BP, hypotensive episodes, cardiac arrest, UOP, oliguria
• Current medications/transfusion history
• Medical or social history
• Family history of diabetes insulin protocol
• Serum amylase
• Sepsis
• HLA (A, B, Bw4, Bw6, C, DR, DR51, DR52, DR52, and DQB antigens)

Question 12

The transplant coordinator must obtain consent from the recipient for a KDPI > than what?
A. 50%
B. 60%
C. 75%
D. 85%

Answer 12

D

Question 13

What 3 things must the transplant coordinator document that are communicated to the recipient?

Answer 13

• Donor Risk Criteria
• DCD Donor
• Research protocols

Question 14

What is required with discovery of new donor disease or malignancy?

4 items

Answer 14

• notify recipient of transmissible disease
• Document new info in EMR
• Follow a recipient that is at increased risk
• Offer recipient additional testing, monitoring, and treatment