Glossary

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Actionable Donor Designations

Taking the appropriate steps in one’s home state to ensure that a personal decision to become a donor is recognized and honored.

 

Allocation

The process of determining how organs are distributed. Allocation includes the system of policies and guidelines, that ensure organs are distributed in an equitable, ethical and medically sound manner.

 

Allocation Policies

Rules established by the OPTN to guide and regulate organ allocation and distribution in the United States.

 

Best Practices

Processes and activities shown in practice to be the most effective.

 

Blood Type

One of four groups (A, B, AB or O) into which blood is classified. Blood types are based on differences in molecules (proteins and carbohydrates) on the surface of red blood cells.

 

Candidate

A person registered on the organ transplant waiting list. When an organ is offered on behalf of the candidate, he or she is then referred to as a Potential Transplant Recipient (PTR).

 

Collaborative

A time-limited effort (usually six to 12 months) of multiple organizations that come together with faculty to learn about and to create improved processes in a specific topic area. The expectation is that the teams share expertise and data with each other, thus “everyone learns, everyone teaches.”

 

Conversion, conversion rate

The percentage of times a death meeting eligible criteria (eligible death) becomes an actual donor.

 

Criteria (Medical Criteria)

A set of clinical or biologic standards or conditions that must be met.

 

Crossmatch

A blood test to determine compatibility between donor and recipient. A positive crossmatch indicates incompatibility. If the crossmatch is “negative,” then the transplant may proceed. Crossmatching is performed for many organ transplants.

 

Deceased Donor

An individual from whom at least one solid organ is recovered or the purpose of transplantation after suffering brain death or cardiac death

 

Deceased Donor Transplant

The transplant of an organ from a deceased donor.

 

Diabetes

A disease in which the pancreas does not manufacture an adequate amount of insulin. As a result, the level of sugar in the blood is too high. A leading factor in heart and kidney disease.

 

Donate Life America

Formerly the Coalition on Donation, Donate Life America is a national not-for-profit alliance of local affiliates and corporate partners that joined forces to inspire all people to Donate Life® through organ, eye and tissue donation. At the core of the organization’s education efforts are the ongoing qualitative and quantitative research of public attitudes about organ, eye and tissue donation and the development and dissemination of effective, motivating public service campaigns. Distributed at the national and community level, these multi-media campaigns effectively communicate two core messages: “Transplants give people their life back,” and “Here is how you can help.”

Founded by the transplant community in 1992, Donate Life America publishes brochures, program kits and other materials; provides technical assistance, training, information and referral services; and coordinates the National Campaign for Organ, Eye and Tissue Donation. It is comprised of national organizational members and local coalitions across the U.S. that coordinate donation related activities at the local level. Volunteer advertising agencies work with the Coalition and its committees to develop targeted mass media campaigns.

 

Donate LifeSM, Done VidaSM

Since 2000, Donate Life and its Spanish-translation Done Vida have been the primary slogans and service mark logos of Donate Life America, promoting donation as a forthright, life-affirming action. Donate Life America encourages the widest possible use of its logos and materials in order to provide a sustained, unified national message about donation. Guidelines and policies are in place to ensure consistency, appropriate use, and the integrity of these national logos and materials.

 

Donor

Someone from whom at least one organ or tissue is recovered for the purpose of transplantation. A deceased donor is a patient who has been declared dead using either brain death or cardiac death criteria, from whom at least onevascularized solid organ is recovered for the purpose of organ transplantation. A living donor is one who donates an organ or segment of an organ for the intent of transplantation.

 

Donor Designation Collaborative

Donate Life America program launched in 2006 to increase Actionable Donor Designations in the United States by identifying and spreading best practices in the areas of measurement and analysis; effective partnerships and relationships; and registry development, management and promotion.

 

End-Stage Organ Disease

A disease that leads to the permanent failure of an organ.

 

High Blood Pressure

When the force of the blood pushing against the walls of the blood vessels is higher than normal because the blood vessels have either become less elastic or have gotten smaller. High blood pressure causes the heart to pump harder to move blood through the body. High blood pressure can cause kidney failure and heart disease if not treated.

 

Hypertension
High blood pressure. Occurs when the force of the blood pushing against the walls of the blood vessels is higher than normal because the blood vessels have either become less elastic or have gotten smaller. Hypertension causes the heart to pump harder to move blood through the body. It can cause kidney failure and heart disease if not treated.

 

Immunosuppressive

Relating to the weakening or reducing of your immune system’s responses to foreign material; immunosuppressive drugs reduce your immune system’s ability to reject a transplanted organ.

 

Kidneys

A pair of organs that remove wastes from the body through the production of urine. All of the blood in the body passes through the kidneys about 20 times every hour. Kidneys can be donated from living and deceased donors and transplanted into patients with kidney failure.

 

Liver

The largest organ in the body, made up of a spongy mass of wedge-shaped lobes. The liver secretes bile, which aids in digestion, helps process proteins, carbohydrates, and fats, and stores substances like vitamins. It also removes wastes from the blood. A living donor can give part of their liver, after which the liver will regenerate itself in both the donor and recipient.

 

Living Donation

When a living person gives an organ or a portion of an organ for use in a transplant. A kidney, or portion of a liver, lung, pancreas or intestine may be donated. See also Living Donor, Organ Donation.

 

Living Donor

A living person who donates an organ for transplantation, such as a kidney or a segment of the lung, liver, pancreas, or intestine. Living donors may be blood relatives, emotionally related individuals, or altruistic strangers. These may also include domino heart or liver transplants.

 

Lungs

The organs of respiration in which aeration of the blood takes place, consisting of a right and left lung divided into lobes. The right lung has three lobes and the left lung has two lobes.

 

Match

The compatibility between the donor and the recipient. The more appropriate the match, the greater the chance of a successful transplant.

 

Match Run

A computerized ranking of transplant candidates based upon donor and candidate medical compatibility and criteria defined in OPTN policies.

 

Medicare

The program of the Federal government that provides hospital and medical insurance, through social security taxes, to people age 65 and over, those who have permanent kidney failure and certain people with disabilities.

 

Model for Improvement

An approach to process improvement, developed by Associates in Process Improvement, which helps teams accelerate the adoption of proven and effective changes. See also Plan-Do-Study-Act.

 

Organ

A part of the body made up of tissues and cells that enable it to perform a particular function. Transplantable organs are the heart, liver, lungs, kidneys, pancreas and intestines.

 

Organ Donation

To give an organ or a part of an organ to be transplanted into another person. Organ donation can occur with a deceased donor, who can give kidneys, pancreas, liver, lungs, heart, intestinal organs, and with a live donor, who can give a kidney, or a portion of the liver, lung, or intestine.

 

Organ Placement Process

When organs are donated, the host OPO accesses the national transplant computer system through the Internet, or contacts the Organ Center at UNOS. Information about the donor is entered into the system and a donor/recipient match is run for each donated organ. The resulting match list of potential recipients is ranked according to criteria defined in that organ’s allocation policy (i.e. 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). Each organ has its own specific criteria.

Using the match list of potential recipients, the host OPO’s organ procurement coordinator or the Organ Placement Specialist in the Organ Center contacts the transplant center of the highest ranked patient, based on policy criteria, to be offered the organ. If the organ is turned down, the next potential recipient’s transplant center on the match list is contacted until the organ is placed. Once the organ is accepted for a patient, transportation arrangements are made and transplant surgery is scheduled. See also, Wait List, Wait List Registration, Waiting Time.

 

Organ Placement Specialist

Organ Center personnel responsible for coordinating the organ matching process among OPTN members.

 

Organ Preservation

Methods used to preserve organs while they are out of the body, between procurement from a donor and transplantation into a recipient.

 

Organ Procurement

The removal or retrieval of organs from a donor for transplantation.

 

Organ Procurement and Transplantation Network (OPTN)

In 1987, Congress passed the National Organ Transplant Act that mandated the establishment of the OPTN and Scientific Registry of Transplant Recipients. The purpose of the OPTN is to improve the effectiveness of the nation’s organ procurement, donation and transplantation system by increasing the availability of and access to donor organs for patients with end-stage organ failure. The Act stipulated that the Network be a non-profit, private sector entity comprised of all U.S. transplant centers, organ procurement organizations and histocompatibility laboratories. These members along with professional and voluntary healthcare organizations and the representatives of the general public are governed by a Board of Directors which reports to the Division of Transplantation, HRSA and ultimately HHS. UNOS holds the OPTN contract.

 

Organ Procurement Organization (OPO)

An organization designated by the Centers for Medicare and Medicaid Services (CMS) and responsible for the procurement of organs for transplantation and the promotion of organ donation. OPOs serve as the vital link between the donor and recipient and are responsible for the identification of donors, and the retrieval, preservation and transportation of organs for transplantation. They are also involved in data folow-up regarding deceased organ donors. As a resource to the community OPOs engage in public education on the critical need for organ donation. See also Donation Service Area (DSA).

 

Pancreas

Irregularly shaped gland that lies behind the stomach and secretes pancreatic enzymes into the small intestines to aid in the digestion of proteins, carbohydrates and fats. Islet cells within the pancreas secrete glucagon, which regulates blood sugar levels and insulin, which lowers blood sugar levels. If the pancreas fails, the individual becomes diabetic, and may need to take insulin. The pancreas can be donated and transplanted.

 

Patient Survival

The length of time a patient survives after receiving a transplant.

 

Placement

The process of alocating donated organs via the match system.

 

Potential Donor

A patient who meets the criteria for brain death with no absolute contraindications to organ donation as defined by a standardized list from the International Classification of Diseases, Ninth Revision.

 

Procurement

The surgical procedure of removing an organ from a donor. Also referred to as recovery.

 

Recipient

A person who receives a transplant.

 

Recovery (Organ)

The surgical procedure of removing an organ from a donor.

 

Rejection

A phenomenon that occurs when a recipient’s immune system attacks a transplanted organ, tissue, or cell. Immunosuppressive drugs help prevent or treat rejection.

 

Renal

Having to do with, or referring to, the kidneys.

 

Retransplantation

Due to rejection or failure of a transplanted organ, some patients receive another transplant.

 

Retrieval

The surgical procedure of organ recovery. Also referred to as procurement.

 

Split Liver

A split liver transplant occurs when the donor liver is divided into segments and then transplanted. These segments may be transplanted into more than one recipient, or a segment could be transplanted into a child for whom an entire adult liver would be too large.

 

Status

An indication of the degree of medical urgency for patients awaiting heart or liver transplants. Examples: status 1A, status 1B, or status 2.

 

Survival Rates

Survival rates indicate the percentage of patients that are alive and the grafts (organs) that are still functioning after a certain amount of time. Survival rates are used in developing OPTN policy.

 

Tissue

An organization of a great many similar cells that perform a special function. Examples of tissues that can be transplanted are blood, bones, bone marrow, corneas, heart valves, ligaments, saphenous veins, and tendons.

 

Tissue Typing

A blood test that helps evaluate how closely the tissues of the donor match those of the recipient.

 

Transplant Center

A hospital that performs transplants, including qualifying patients for transplant, registering patients on the national waiting list, performing transplant surgery and providing care before and after transplant.

 

Transplant Team

The diverse group of professionals at the transplant center who work to make a transplant successful. Each person on the “transplant team” is an expert in a different area of transplantation. The transplant team includes all or some of the following professionals:

  • Clinical transplant coordinators have responsibility for the patient’s evaluation, treatment, and follow-up care.
  • Transplant physicians are doctors who manage the patient’s medical care, tests, and medications. He or she does not perform surgery. The transplant physician works closely with the transplant coordinator to coordinate the patient’s care until transplanted, and in some centers, provides follow-up care to the recipient.
  • Transplant surgeons perform the transplant surgery and may provide the follow-up care for the recipient. The transplant surgeon has special training to perform transplants.
  • Financial coordinators have detailed knowledge of financial matters and hospital billing. The financial coordinator works with other members of the transplant team, insurers, and administrative personnel to coordinate and clarify the financial aspects of the patient’s care before, during, and after the transplant.
  • Social workers help patients and their families understand and cope with a variety of issues associated with a patient’s illness and/or the various side-effects of the transplant itself. In some cases, the social worker may perform some of the financial coordinator duties as well.

 

United Network for Organ Sharing (UNOS)

The private, nonprofit membership organization that coordinates the nation’s transplant system through HRSA’s OPTN contract. As OPTN contractor, UNOS is responsible for meeting all contract requirements. As contractor since the first OPTN contract award in 1986, UNOS has established and continually strives to improve tools, systems and quality processes that support OPTN contract objectives and requirements. These include:

  • Managing the national organ transplant waiting list
  • Collecting, managing and reporting of sensitive clinical data in a secure, fail-safe environment
  • Facilitating an open, inclusive forum for development and continuous refinement of evidence-based policies and standards
  • Member and policy performance assessment to ensure equitable, safe treatment of candidates and recipients
  • Increasing donation and making the most of every organ that is donated through professional education, outcomes research, patient services and resources and public and professional education
  • Continuously improving the care, quality of life and outcomes of organ transplant candidates and recipients

 

Ventilator

A machine that “breathes” for a patient when the patient is not able to breathe properly.

 

Wait List

The list of candidates registered to receive organ transplants. When a donor organ becomes available, the matching system generates a new, more specific list of potential recipients based on the criteria defined in that organ’s allocation policy (e.g., organ type, geographic local and regional area, genetic compatibility measures, details about the condition of the organ, the candidate’s disease severity, time spent waiting, etc.).

 

Waiting Time

The amount of time a candidate is on the Wait List. Waiting times can be influenced by many factors, including:

  • blood type (some are rarer than others)
  • tissue type
  • height and weight of transplant candidate
  • size of donated organ
  • medical urgency
  • time on the waiting list
  • the distance between the donor’s hospital and the potential donor organ
  • how many donors there are in the local area over a period of time
  • the transplant center’s criteria for accepting organ offers