SPDX ORGAN DONATION

• Pretransplant evaluation

  Identifies opportunities to assess the risks for common post-transplant infections and to develop individualized preventative strategies
• Goals of Pretransplant Screening

  • To identify conditions which may disqualify either donor or recipient
• Screening of donor and recipient

  • Bacterial Infections
  • Parasitic Infections
  • Endemic Fungal Infections
  • Viral Infections
• Syphilis tests

  • Non-treponemal tests detect antibodies against cardiolipin and are not specific
  • Treponemal tests detect antibodies against specific treponemal antigens
• Tuberculosis assessment

  • Tuberculin skin test (TST) elicits a delayed–type hypersensitivity reaction
  • Interferon gamma release assays (IGRA) measure T cell release of interferon gamma (IFN-γ) following stimulation with antigens present in M. tuberculosis
• Toxoplasmosis test

  Detection of specific IgG antibodies
• Strongyloidiasis test

  Serial stool ova and parasite examinations and Strongyloides IgG measured by ELISA
• Post-transplant histoplasmosis is rare, with an estimated incidence <1%, even in endemic areas
• Screening for HIV is required in pre-transplant evaluations
• HBV and HCV screening

  • Screening for HCV with antibodies is routine among SOT candidates
  • A reactive or indeterminate/equivocal antibody test should be followed by HCV RNA testing
  • Screening tests for HBV include hepatitis B surface antigen, surface antibody, and core antibody
• Major Responsibilities of Transplant Coordinator


  • Direct Patient Care
  • Program Development
  • Research
  • Education
  • Consultation
• Direct Patient Care Responsibilities


  • Conduct pre-transplant interviews with prospective transplant patients and families
  • Prepare and analyze pre-transplant clinical data and collaborate with other medical personnel in preparation of patients and families for transplantation
  • Coordinate pre-transplant preparations
  • Educate patients and families regarding all aspects of transplantation
  • Communicate with third-party payers regarding issues of medical necessity and benefits coverage
  • Compose written transplant summaries, clinic visit and summaries and letters
  • Conduct post-discharge planning and education for transplant patients
  • Compile and review post-discharge data for clinical management of transplant patients
  • Provide direct care to transplant patients in the Outpatient Transplant Clinic
  • Provide for continuity of care between inpatient admissions and outpatient visits
  • Collaborate with medical faculty, other transplant coordinators, nursing personnel and other health disciplines to facilitate meeting patient and family needs
  • Select appropriate patients for organ transplantation based on UW Health Transplant Program and UNOS guidelines
  • Provide telephone consultation and follow-up to support patients and their families
  • Implement and coordinate the education, selection and preparation for live kidney donors
  • Provide on-call service for items 12-14 on evenings, weekends and holidays when the transplant office and Clinic is closed
• Program Development Responsibilities


  • Collaborate in the development of protocols and guidelines for patient management
  • Develop, implement and evaluate comprehensive patient education programs
  • Participate in the development and execution of quality assurance programs and projects
• Research Responsibilities


  • Support planning of and participate in clinical research projects
  • Participate in the development and implementation of research protocols and interpret the protocols for participation of patient and family members
  • Collect and analyze data for ongoing clinical research projects
  • Incorporate research findings into the Organ Transplant Program Practice
• Education Responsibilities


  • Participate in teaching activities at UW Health for physicians, nurses, allied health professionals and for students in those disciplines
  • Develop and present information to professional groups regarding organ transplantation and organ donation
  • Develop and present information to community groups regarding organ transplantation and organ donation
  • Participate in the development of marketing information regarding organ transplantation and organ donation
• Consultation Responsibilities


  • Provide consultation to UW Medical Faculty, other physicians, nurses and other health care professionals who provide health care to organ transplant patients
  • Provide status reports to third-party payors
  • Provide patient status reports to community and referring physicians