Renal Transplant News

Recent Expansions in Donor Criteria Impact Those on the Waiting List

Rachel Dowell-Cherry, R.N., C.C.T.C.		Jennifer Hinkis, R.N., C.C.T.C.
Q & A with Rachel Dowell-Cherry, R.N., C.C.T.C., Transplant Coordinator, Saint Barnabas Medical Center, and Jennifer Hinkis, R.N., C.C.T.C., Transplant Coordinator, Newark Beth Israel Medical Center

The United Network for Organ Sharing (UNOS), the governing body for all organ procurement centers in the United States, recently implemented a new policy which asks all kidney transplant candidates if they will accept an organ from a deceased donor who meets "expanded criteria." The following are frequently asked questions about this new policy:

1. What is an expanded criteria donor kidney as defined by UNOS?

The UNOS expanded criteria for kidney donors include deceased donors who are

- Over age 60,
- or Between the ages of 50 - 60 and meet two of the following criteria:

• Donor died from a stroke

• Donor had a history of high blood pressure

• Donor had a serum creatinine greater than 1.5 at the time the kidney was donated

2. Do these expanded criteria create a new or secondary source for donated organs?

No. Many of these are the same kinds of donated kidneys that the Saint Barnabas Health Care System and other experienced transplant centers across the country have been successfully transplanting for 10 years. While scientific studies have shown that transplants performed with expanded criteria donor kidneys may be just as successful as those involving ideal donors, there is an increased risk that these kidneys may not function immediately after transplantation. There may also be a slightly reduced one year graft survival rate (85-90 percent vs. 90-95 percent). 

3. Why is UNOS asking transplant candidates to sign a form indicating that they will or will not accept a kidney from an expanded criteria donor?

The goal is to make the greatest use of all viable organs. UNOS has requested that each transplant center obtain the patient’s consent if they wish to be considered for expanded criteria donor kidney offers.

4. I’m not comfortable making this decision alone. Can someone help me?

Team members always assist the patient in reviewing each transplant opportunity on an individual basis. The UNOS expanded criteria are only a few of the many facts considered when deciding if a kidney can be donated. The health history and lifestyle of the donor, and the condition of the donated organ are other important considerations. At any time in the process, the candidate has the right to decline an organ.

5. How will this decision affect my chances for a transplant?

With the demand for organs growing and the availability of donated organs leveling off, a larger percentage of the organs available for transplantation are from UNOS expanded criteria kidney donors. Candidates who consent to be considered when an expanded criteria donor kidney is offered, keep all of their options for transplantation open. Candidates who do not wish to be considered for an expanded criteria donor kidney limit their overall chances for transplantation.

For further information, call your transplant coordinator or Saint Barnabas Medical Center: 973-322-5938 Newark Beth Israel Medical Center: 973-926-7555.

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