We get a lot of questions about how long Noah will have to wait for a new heart. There are many factors that go into matching a donor with a recipient, and there aren’t enough donors, so there is no way to predict when that will happen for us.
How it happens? The Donor Matching System
When transplant hospitals accept patients onto the waiting list, the patients are registered in a centralized, national computer network that links all donors and transplant candidates. The UNOS Organ Center is staffed 24 hours a day throughout the year, and it assists with the matching, sharing and transportation of organs via this computer network.
Transplant centers and OPOs are involved in the organ sharing process. When donor organs are identified by an OPO (see below), the procuring organization typically accesses the computerized organ matching system, enters information about the donor organs, and runs the match program.
For each organ that becomes available, the computer program generates a list of potential recipients ranked according to objective criteria (i.e. blood type, tissue type, size of the organ, medical urgency of the patient, time on the waiting list, and distance between donor and recipient). Each organ has its own specific criteria. Ethnicity, gender, religion, and financial status are not part of the computer matching system.
Waiting times vary widely for many reasons. The shortage of organs causes most patients to wait for a transplant. The amount of time a patient waits does not show how well a transplant center or OPO is doing its job. Each patient’s situation is different. Some patients are more ill than others when they are put on the transplant waiting list. Some patients get sick more quickly than other patients, or respond differently to treatments. Patients may have medical conditions that make it harder to find a good match for them.
After printing the list of potential recipients, the procurement coordinator contacts the transplant surgeon caring for the top-ranked patient to offer the organ. Depending on various factors, such as the donor’s medical history and the current health of the potential recipient, the transplant surgeon determines if the organ is suitable for the patient. If the organ is turned down, the next listed individual’s transplant center is contacted, and so on, until the organ is placed.
Once the organ is accepted for a potential recipient, transportation arrangements are made for the surgical teams to come to the donor hospital and surgery is scheduled. For heart, lung, or liver transplantation, the recipient of the organ is identified prior to the organ recovery and called into the hospital where the transplant will occur to prepare for the surgery.
The recovered organs are stored in a cold organ preservation solution and transported from the donor to the recipient hospital. For heart and lung recipients, it is best to transplant the organ within six hours of organ recovery. For kidneys/pancreas, lab tests designed to measure the compatibility between the donor organ and recipient are performed. A surgeon will not accept the organ if these tests show that the patient’s immune system will reject the organ. Therefore, the recipient is usually not identified until after these organs are recovered.
How do organs initially become available?
Organ Procurement Organizations (OPOs)
The role of the organ procurement organization (OPO) is very important in the matching process. OPOs become involved when a patient is identified as a potential donor. The OPO coordinates the logistics between the organ donor’s family, the donor organs, the transplant center(s), and the potential transplant candidate.
OPOs provide organ recovery services to hospitals located within designated geographical area of the U.S. OPOs are non-profit organizations and, like transplant hospitals, are members of the OPTN and have a medical director on staff who is usually a transplant surgeon or physician.
Once contacted by the hospital with a potential donor, OPO staff:
- conduct a thorough medical and social history of the potential donor to help determine the suitability of organs for transplantation
- work with hospital staff to offer the option of donation to the donor family
- ensure that the decision to donate is based on informed consent
- manage the clinical care of the donor once consent for donation is finalized
- enter the donor information into the UNOS computer to find a match for the donated organs
- coordinate the organ recovery process with the surgical teams and provide follow-up information to the donor family and involved hospital staff regarding the outcome of the donations
From the moment of consent for donation to the release of the donor’s body to the morgue, all costs associated with the organ donation process are billed directly to the OPO.
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