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Pre-implementation notice: Updates to living donor exclusion criteria

Pre-implementation notice: Updates to living donor exclusion criteria

Audience 

  • Kidney Paired Donation Primary Contacts
  • Kidney, Liver and VCA Living Donation TX Program Administrators/Managers, TX Program Directors, TX Program – Clinical Coordinators, Compliance Officers, Social Workers-Tx Program, Compliance Officers, Quality Coordinators, Quality Directors/Managers, Support Staff Clinical, Independent Living Donor Advocates
  • Kidney, Liver and VCA Living Donation Program Administrators, Primary Physicians, Primary Surgeons, Primary Donor Surgeons-Open Nephrectomies, Primary Donor Surgeons-Laparoscopic Nephrectomies, Primary Clinical Consultants

Implementation date

July 26, 2022

At-a-glance

Four exclusion criteria in OPTN Policy 14.4.E Living Donor Exclusion Criteria will be updated to align with current research and guidelines as well as ensure consistency throughout OPTN policy language. When implemented, these changes will give transplant programs more autonomy when evaluating individuals with malignancies and type 2 diabetes for living donation.

Additional information

Updates to OPTN policy language will impact four living donor exclusion criteria:

  • Malignancy exclusion criterion
    • Updates will specify that individuals with malignancies that require treatment, other than surveillance, or have a more than known minimal risk of transmission are excluded from being living donors
  • Diabetes exclusion criterion
    • Updates will maintain type 1 diabetes as an absolute contraindication to living kidney donation
    • Updates will specify that individuals with type 2 diabetes that have evidence of end organ damage or unacceptable lifetime risk of complications as determined by a transplant program’s individualized assessment of donor demographics and comorbidities are excluded from being living kidney donors
  • Coercion exclusion criterion
    • Updates will align language with other references in OPTN living donor policy
  • Illegal exchange exclusion criterion
    • Updates will align language with other references in OPTN living donor policy

For more information and further details, read the briefing paper.

What you need to do

The updates to living donor exclusion criteria do not require transplant programs to change their living donor and acceptance practices. These policy changes take effect July 26.

Should a transplant program choose to expand their living donor evaluation and acceptance practices, there may be additional administrative burden for the program to adapt evaluation protocols.

Education and resources

Professional education will be available on this policy change in UNOS Connect on July 19. A separate communication will be sent to members on this day with more details.

DON107: Living Donor Exclusion Criteria

The OPTN Board of Directors approved this policy change at its June 2022 meeting. Visit the OPTN public comment page for this proposal to learn more.

Questions?

For policy-related questions, contact member.questions@unos.org

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