New Kidney Allocation and What it Means to Your Transplant Center and Your Patients
|
|
- Laureen Shelton
- 7 years ago
- Views:
Transcription
1 New Kidney Allocation and What it Means to Your Transplant Center and Your Patients Alexander Wiseman, M.D. Professor, Division of Renal Diseases and Hypertension Medical Director, Kidney and Pancreas Transplant Programs University of Colorado Health Sciences Center
2 The Kidney Transplant Waiting List: How do you get priority points in 2013? Time: Longest wait =1 point, with fractions of a point given for each candidate in order 1 Year=1 point Match: HLA DR match=1 point for each DR locus that is not mismatched (maximum of 2) Sensitization: Panel reactive antibody level>80%=4 points Good Samaritan: Prior kidney donation=4 points UNOS Policy 3.5
3 Case 1 A 24 y/o male is declared brain dead following an MVA and is an organ donor. Perfect health prior to MVA. The match run performed by UNOS identifies a recipient with the highest priority: 74 y/o man with DM, CAD s/p CABG, on dialysis/listed for 3 years, panel reactive antibody= 10% HLA DR matched at both loci=2 points 3 years of wait time=3 points Total=5 points
4 Case continued: #2 on the match run is a 30 yo female with IgA nephropathy on dialysis/waiting list for 3 years with a PRA of 70%, 4 Ag match (2 A, 1 B, 1 DR), listed with a different transplant program in the area HLA DR matched at one loci=1 point 3 years of wait time=3 points Total points=4 #3 on the match run is a 50 y/o with PKD, PRA 0% and no other medical problems on the waiting list for 4 years, potential 4 Ag match (2 A, 2 B) 4 years of wait time=4 points Total points=4
5 Major Rationale for Change The current system Uses few available objective medical criteria Kidneys with long projected post-transplant survival are allocated to candidates with short post-transplant survival (and vice versa)
6 Objectives for the Proposed Kidney Allocation System Improve outcomes of recipients of deceased donor kidneys through improved matching of graft/recipient projected survival Improve access for biologically disadvantaged kidney transplant candidates (highly sensitized, blood group B, minority candidates)
7 Overview of proposed policy Current Proposed All allocation sequences to be based on kidney donor profile index (KDPI)
8 Factors used to determine groups KDPI Donor age Race/ethnicity Hypertension Diabetes Serum creatinine COD CVA Height Weight DCD HCV Candidate Estimated Post-Transplant Survival (EPTS) Candidate Age Candidate Diabetes Prior transplant ESRD time
9 Overview of proposed policy Proposed Allocation to those with longest expected posttransplant survival Allocation first to Pediatric list, then according to waiting time Allocation according to waiting time Allocation to those who consent (similar to today s ECD ) All allocation sequences to be based on kidney donor profile index (KDPI)
10 Kidney Donor Profile Index (KDPI) KDPI Variables Donor age Height Weight Ethnicity History of Hypertension History of Diabetes Cause of Death Serum Creatinine HCV Status DCD Status
11 Case (for the referring nephrologist): Your 55 yo patient with T2DM, not yet on dialysis (but is close, with GFR 13) has consented to a KDPI >85. He gets an offer for a kidney that has KDPI of >85. Do you: A. Advise him to take it B. Advise him to decline it C. Ask about the KDPI
12 Case (for the transplant center): You receive an offer for a 55 yo patient with T2DM, not yet on dialysis (but is close, with GFR 13) who has consented to a KDPI >85. The donor is a 59 yo obese AA with CVA and HTN. The KDPI is 95. Do you: A. Accept the kidney B. Decline the kidney
13 Highly sensitized patients rarely get offers under current allocation policy
14 New Policy: Sensitization Points (Current) (Proposed) Current policy awards 4 points to candidates with PRA>80% Candidates <80% do not receive any points Proposed policy would generate a sliding scale for priority so that highly sensitized candidates get improved access
15 Modeling transplant results by CPRA (95-100%)
16 Projected results >8000 additional life years annually Slight increase in transplants to African Americans, blood type B, and high PRA recipients % of transplants current estimated Changes in age distribution < Recipients, by age
17 Allocation Scheme
18 Scenario 1: 48 yo with FSGS on HD for 7 years, variably adherent, missed transplant evaluations x 2 in past (illness). Still modestly nonadherent. Makes appointment, is ultimately placed on waiting list. Scenario 2: 68 yo with DM on HD for 2 years, very adherent, missed transplant evaluation in past (illness). Still very functional on CCPD, is ultimately placed on waiting list.
19 Proposed Point Changes: Waiting Time Current policy begins waiting time points for adults at registration with: GFR<=20 ml/min Dialysis time Proposed policy would also award waiting time points for dialysis time prior to registration Applies to both pediatric and adult candidates Better recognizes time spent with ESRD as the basis for priority Pre-emptive listing would still be advantageous for 0-ABDR mismatch offers
20 Discussion For the physician: How do you educate patients regarding new allocation policies? For the transplant center: How do you manage the waiting list with the new allocation policies?
21 Conclusions KDPI will permit efficient allocation but does not necessarily increase number of transplants, unless demand for high KDPI increases Sliding scale for sensitization/%pra are components that have gained approval
22 Case A 17 yo patient with Henoch-Schonlein Purpura (HSP) and CKD V not yet on dialysis She has a family member who is interested in donating with compatible blood type. Average waiting time for an adult blood type O candidate is 5 years What is the likelihood that she will get an offer for a kidney within 2 months? 12 months? What do you recommend: A) living donor transplant B) wait for deceased donor transplant
23 Pediatric Kidney Allocation
24 Pediatric kidney transplantation With introduction of Share 35 in November 2005 (in which all deceased donors < 35y are offered first to candidates <18y), waiting time is shorter, rates of living donation have fallen Age at Registration <1 Year Years Years Years Years Is shortening pediatric waiting time by 2-4 months really the best strategy? SRTR Annual Report 2011 Fig 8.13
25 Inferior outcomes with deceased donor vs living donor in pediatric recipients Higher acute rejection rates Worse graft survival Is the shorter waiting time worth the de-emphasis on living donation? SRTR Annual Report 2011 Figs 8.26, 8.27
26 Utility of Share 35 donor kidneys are NOT optimized by use in pediatric population Using Share 35 donors, overall graft survival and deathcensored graft survival is better in adults than those 17 Higher graft loss in younger recipients Higher death rate in older recipients Best utility is in recipients age 31-45, not the pediatric recipients Moudgil A et al, Transplantation 2013; 95:319
27 Pancreas Allocation and Transplantation
28 Patients receiving SPK transplants have the greatest net lifetime benefit * from transplantation *(estimated survival with functioning graft) - (estimated survival on dialysis x 0.8) 4% 32% 64% Wolfe R et al, AJT 2008; 8:
29 Organ Allocation: The kidney follows the pancreas Organ Donor: 2 kidneys, 1 pancreas Pancreas list A (E on kidney list) B C (G on kidney list) D Kidney list A B C D E F G If Pancreas follows kidney : Candidates A and B get kidneys, and B gets panc If Kidney follows pancreas : Candidate A gets kidney, and E gets SPK INCENTIVE TO PUT PATIENTS ON SPK LIST (EVEN T2DM???)
30 Organ Allocation for Diabetes: The kidney follows the pancreas Median waiting time to transplant (days) 2004 SPK A: 323 B: 520 O: 533 AB:214 Kidney A: 815 B: 1655 O: 1568 AB: 602 INCENTIVE TO PUT PATIENTS ON SPK LIST (EVEN T2DM???) SRTR Annual Report 2009
31 Case 46 yo man with T1DM who underwent SPK transplant after only 14 months of waiting tells his buddy with T2DM on dialysis how great it is to be off dialysis and without insulin. His buddy, a 49 yo with BMI 29, has been waiting on the kidney transplant waiting list for 2 years and wonders if he can undergo an SPK transplant What do you advise him? A) He is not a candidate due to T2DM B) SPK is much less successful in T2DM than T1DM C) SPK may be a reasonable option
32 Simultaneous Pancreas Kidney Transplantation: For T2DM? In U.S.-Eligibility for SPK waiting list: 1. DM with c-peptide <2 ng/ml 2. DM, c-peptide >2 ng/ml with BMI <28-30kg/m 2
33 Pancreas transplant outcomes are equivalent in T1DM vs. selected T2DM OPTN/UNOS Data analysis of SPK recipients T2DM recipients vs 6141 T1DM recipients Patient Survival Pancreas Graft Survival Pancreas-related complications T1DM T2DM P One-year kidney and/or pancreas rejection Pancreas complications abscess/local infection anastomosis leak pancreatitis primary nonfunction surgery to convert bladder to enteric drainage Sampiao M et al, CJASN 2011; 6: 1198
34 Does the added pancreas transplant lead to better outcomes for young, thin patients with T2DM? SRTR analysis of patients with T2DM, age 18-59, with BMI kg/m 2 receiving an SPK (n=424), LDKA or DDKA during : Multivariate analysis: HR 0.9 (p=ns) Multivariate analysis: HR 0.5 (p<0.001)) SPK: better patient survival than DDKA, but inferior compared to LDKA SPK: Waiting time much shorter, donor age much younger than DDKA Wiseman AC and Gralla J, CJASN 2012 Apr;7(4):656
35 Summary/Conclusion: SPK as a Transplant Option Avoid dialysis know the waiting time expectations for SPK and advise your patients accordingly For most T1DM: SPK is preferable to deceased donor kidney transplant. LD kidney transplant vs SPK: depends on dialysis/waiting time For most T2DM: LD > DD <10% of T2DM may be eligible for SPK, better than DD but may be inferior to LD
*6816* 6816 CONSENT FOR DECEASED KIDNEY DONOR ORGAN OPTIONS
The shortage of kidney donors and the ever-increasing waiting list has prompted the transplant community to look at different types of organ donors to meet the needs of our patients on the waiting list.
More informationThe New Kidney Allocation System: Resources for Protocols and Processes webinar.
The New Kidney Allocation System: Resources for Protocols and Processes webinar. 1 Speakers for the webinar are: Dr. Richard Formica Associate Professor of Medicine and Surgery, Yale University School
More informationWhere Will my New Kidney Come From?
Where Will my New Kidney Come From? The Organ Shortage There is a severe shortage of organs for transplant. This means that the wait for a kidney transplant can be many years. The UW Transplant Program
More informationQuestions and Answers for Transplant Candidates about the New Kidney Allocation System
TA L K I N G A B O U T T R A N S P L A N TAT I O N U N I T E D N E T W O R K F O R O R G A N S H A R I N G Questions and Answers for Transplant Candidates about the New Kidney Allocation System United
More informationSaint Francis Kidney Transplant Program Issue Date: 6/9/15
Kidney Transplant Candidate Informed Consent Education Here are educational materials about Kidney Transplant. Please review and read these before your evaluation visit. The RN Transplant Coordinator will
More informationTHE BENEFITS OF LIVING DONOR KIDNEY TRANSPLANTATION. feel better knowing
THE BENEFITS OF LIVING DONOR KIDNEY TRANSPLANTATION feel better knowing your choice will help create more memories. Methods of Kidney Donation Kidneys for transplantation are made available through deceased
More informationDavid Axelrod, MD, MBA. Associate Professor of Surgery Section Chief- Solid Organ Transplantation Dartmouth- Hitchcock Medical Center
David Axelrod, MD, MBA Associate Professor of Surgery Section Chief- Solid Organ Transplantation Dartmouth- Hitchcock Medical Center Owner of XynManagement which produces software to track and improve
More informationCenter Activity (07/01/2009-06/30/2010) Center Region United States Tables for More Information
Program Summary Center Activity (07/01/2009-06/30/2010) Center Region United States Tables for More Information Deceased donor transplants (n=number) 0 169 0 07C,08C,09C On waitlist at start (n) 0 0 0
More informationDeceased-Donor Renal Transplant Information for patients
Deceased-Donor Renal Transplant Information for patients Exceptional healthcare, personally delivered As part of the work-up for the NHS Blood and Transplant (NHSBT) kidney transplant waiting list, you
More informationKidneys. Kidney Failure4. Transplantation
Kidneys & Kidney Failure4 Transplantation This booklet helps you understand the process of transplantation. It defines the criteria for a donor and the recipient. It also clearly explains the concepts
More informationIs a kidney transplant right for me?
Is a kidney transplant right for me? Your guide to the transplant process www.esrdncc.org Contents Introduction 3 What is a Transplant Center? 4 What is the Waiting List? 5 What Happens After the Surgery?
More informationANNUAL REPORT ON KIDNEY TRANSPLANTATION
ANNUAL REPORT ON KIDNEY TRANSPLANTATION REPORT FOR 2013/2014 (1 APRIL 2004 31 MARCH 2014) PUBLISHED SEPTEMBER 2014 PRODUCED IN COLLABORATION WITH NHS ENGLAND Contents 1 Executive Summary... 1 2 Introduction...
More informationUser Guide. A. Program Summary B. Waiting List Information C. Transplant Information
User Guide This report contains a wide range of useful information about the pancreas transplant program at Saint Louis University Hospital (MOSL). The report has three main sections: A. Program Summary
More informationHow does a kidney transplant differ from dialysis?
TA L K I N G A B O U T T R A N S P L A N TAT I O N Frequently Asked Questions about Kidney Transplant Evaluation and Listing If your kidneys have stopped working properly, or may stop working soon, you
More informationLiving Donor Paired Exchange Registry. What is Living Kidney Donor Paired Exchange?
Living Paired Exchange Registry What is Living Kidney Paired Exchange? The Living Paired Exchange Registry. At Canadian Blood Services, we are committed to helping Canadians help each other. By building
More informationLIVING KIDNEY DONATION
LIVING KIDNEY DONATION 1 THE MICHIGAN DIFFERENCE Why Living Donation? As of May 2011, there were close to 2,500 individuals on the waiting list for a kidney transplant in the state of Michigan and more
More informationRenovascular Hypertension
Renovascular Hypertension Philip Stockwell, MD Assistant Professor of Medicine (Clinical) Warren Alpert School of Medicine Cardiology for the Primary Care Provider September 28, 201 Renovascular Hypertension
More informationKidney Transplant Program. Guide to Understanding Transplant
Kidney Transplant Program Guide to Understanding Transplant The wonderful physicians and staff of the Stanford Kidney Transplant Program are always there to contact if I have a question or concern. They
More informationMaintenance Steroid Avoidance in Pediatric Heart Transplantation is Associated with Excellent Graft Survival
Maintenance Steroid Avoidance in Pediatric Heart Transplantation is Associated with Excellent Graft Survival Scott Auerbach, MD, Jane Gralla, PhD, Shelley Miyamoto, MD, David Campbell, MD, and Biagio Pietra,
More informationMedicine & Emergency Department Pre-transplantation decisions and preparation
Medicine & Emergency Department Pre-transplantation decisions and preparation Information for renal patients Who can have a kidney transplant? Kidney transplantation is the preferred choice of treatment
More informationIs a Kidney Transplant Right for Me?
Is a Kidney Transplant Right for Me? Network 8 Introduction What do singer Natalie Cole, actor Ken Howard, funny men Tracy Morgan and George Lopez and fashion reporter Steven Cojocaru have in common? They
More informationPANCREAS, PANCREAS-KIDNEY, SEGMENT OF PANCREAS AND ISLET PANCREATIC TISSUE TRANSPLANTATION SUR703.013
PANCREAS, PANCREAS-KIDNEY, SEGMENT OF PANCREAS AND ISLET PANCREATIC TISSUE TRANSPLANTATION SUR703.013 COVERAGE: A simultaneous or combined pancreas-kidney transplant (SPK) from a cadaver donor or a simultaneous
More informationCandidates about Multiple Listing and Waiting Time Transfer
TA L K I N G A B O U T T R A N S P L A N TAT I O N Questions & A n s we r s for Transplant Candidates about Multiple Listing and Waiting Time Transfer U N I T E D N E T W O R K F O R O R G A N S H A R
More informationCurrent Renal Replacement Therapy in Korea - Insan Memorial Dialysis Registry, 2011 - ESRD Registry Committee, Korean Society of Nephrology*
Current Renal Replacement Therapy in Korea - Insan Memorial Dialysis Registry, 2011 - ESRD Registry Committee, Korean Society of Nephrology* =Abstracts= Registry committee of Korean Society of Nephrology
More informationExpanded criteria donors for kidney transplantation
American Journal of Transplantation 2003; 3 (Suppl. 4): 114 125 Blackwell Munksgaard 2003 Blackwell Munksgaard ISSN 1601-2577 Expanded criteria donors for kidney transplantation Robert A. Metzger a, Francis
More informationSeeking Normality: Life on the Kidney Transplant List
Seeking Normality: Life on the Kidney Transplant List Seeking Normality: Life on the Kidney Transplant List Magi Sque 1, Jane Frankland 2, Tracy Long-Sutehall 2, Julia Addington-Hall 2, Juan Mason 3 1
More informationTA L K I N G A B O U T T R A N S P L A N TAT I O N
TA L K I N G A B O U T T R A N S P L A N TAT I O N UNITED NETWORK FOR ORGAN SHARING United Network for Organ Sharing (UNOS) is a private non-profit 501(c)(3) organization that operates the Organ Procurement
More informationKidney Disease WHAT IS KIDNEY DISEASE? TESTS TO DETECT OR DIAGNOSE KIDNEY DISEASE TREATMENT STRATEGIES FOR KIDNEY DISEASE
Kidney Disease WHAT IS KIDNEY DISEASE? Kidney disease is when your kidneys are damaged and not functioning as they should. When kidney disease is not going away it is called chronic kidney disease or CKD.
More informationGFR (Glomerular Filtration Rate) A Key to Understanding How Well Your Kidneys Are Working
GFR (Glomerular Filtration Rate) A Key to Understanding How Well Your Kidneys Are Working www.kidney.org National Kidney Foundation's Kidney Disease Outcomes Quality Initiative Did you know that the National
More informationsurvival, morality, & causes of death Chapter Nine introduction 152 mortality in high- & low-risk patients 154 predictors of mortality 156
introduction 152 < mortality in high- & low-risk patients 154 < predictors of mortality 156 < impact of anemia & dialysis therapy on mortality 158 < mortality in esrd patients with rare s 16 < expected
More informationModels of Chronic Kidney Disease Care and Initiation of Dialysis. Dr Paul Stevens Kent Kidney Care Centre East Kent Hospitals, UK
Models of Chronic Kidney Disease Care and Initiation of Dialysis Dr Paul Stevens Kent Kidney Care Centre East Kent Hospitals, UK Early Crash Landings Talk Outline Pathways & Definitions Guideline recommendations
More informationrenal transplantation: A single-center comparative study
Impact of posterior urethral valves on pediatric renal transplantation: A single-center comparative study BY Mohamed Kamal Gheith, MD Oberarzt die Urologie, Universitätsmedizin Mainz Ass. Prof. of Urology,
More informationLIVING DONATION. What You Need to Know. www.kidney.org
LIVING DONATION What You Need to Know www.kidney.org 2 NATIONAL KIDNEY FOUNDATION TABLE OF CONTENTS About Living Donation.... 4 The Evaluation Process.... 6 Surgery and Recovery.... 12 After Donation....
More informationTransplant Options When You Don t Have a Good Match
Transplant Options When You Don t Have a Good Match 1 Transplant Options When You Don t Have a Good Match Being told you need a transplant may bring about many feelings, including anxiety and uncertainty.
More informationKidney Transplantation
ilearning about your health Kidney Transplantation www.cpmc.org/learning What is Kidney Failure? Normally, kidneys filter waste products from your blood, control the balance of salt and water in your body,
More informationKidney Disease: A Silent Problem
Kidney Disease: A Silent Problem kidneys Henry has been having a hard time managing his health. He knows he s got high blood pressure and diabetes, but he just can t resist extra helpings of his wife s
More informationDemystifying Transplant Performance Reviews. Robyn Zernhelt Performance Analyst
Demystifying Transplant Performance Reviews Robyn Zernhelt Performance Analyst Pre-Assessment Transplant Performance Reviews The PAIS reviews which transplant programs? 1. Kidney, Pancreas, Intestine 2.
More informationThe Paired Donation Network. E. Steve Woodle, M.D. Division of Transplantation University of Cincinnati
The Paired Donation Network E. Steve Woodle, M.D. Division of Transplantation University of Cincinnati Paired Donation: Definition In a paired donation, two living kidney donor/recipient pairs (both of
More informationAnalysis of waiting times on Irish renal transplant list
Clin Transplant 2009 DOI: 10.1111/j.1399-0012.2009.01085.x ª 2009 John Wiley & Sons A/S. Analysis of waiting times on Irish renal transplant list Phelan PJ, OÕKelly P, OÕNeill D, Little D, Hickey D, Keogan
More informationIntroduction. Evaluation
Introduction Most patients evaluated for kidney transplantation are already on dialysis, but this is not an absolute requirement. The evaluation process for a kidney transplant ensures that the patient
More informationDefinition, Prevalence, Pathophysiology and Complications of CKD. JM Krzesinski CHU Liège-ULg Core curriculum Nephrology September 28 th 2013
Definition, Prevalence, Pathophysiology and Complications of CKD JM Krzesinski CHU Liège-ULg Core curriculum Nephrology September 28 th 2013 KI supplements January 2013 Objectives of the course on CKD:
More informationChapter 24: Renal Transplantation in the Older Adult
Chapter 24: Renal Transplantation in the Older Adult Erica L. Hartmann Abdominal Organ Transplant Program, Department of Internal Medicine-Nephrology, Wake Forest University Health Sciences, Winston-Salem,
More information4/25/2016. Transplant Journey. Objectives. Reason for Transplantation at Mayo Clinic. Mayo Clinic Model of Care
Transplant Journey Lynette Fix, RN, BAN, CCTC Objectives Identify key components of transplant evaluation process Identify the patient follow-up process Describe diseases indicated for transplantation
More informationSystolic Blood Pressure Intervention Trial (SPRINT) Principal Results
Systolic Blood Pressure Intervention Trial (SPRINT) Principal Results Paul K. Whelton, MB, MD, MSc Chair, SPRINT Steering Committee Tulane University School of Public Health and Tropical Medicine, and
More informationElevated heart rate at twelve months after heart transplantation is an independent predictor of long term mortality
Elevated heart rate at twelve months after heart transplantation is an independent predictor of long term mortality C. Tomas, MA Castel, E Roig, I. Vallejos, C. Plata, F. Pérez-Villa Cardiology Department,
More informationTransplant Coordinator
Have you signed your organ donor card? Hearts, kidneys, livers, and lungs can all be transplanted. When you die, one of your organs could help a critically ill patient live a longer life. What I do every
More informationA07/S/a NHS STANDARD CONTRACT FOR ADULT KIDNEY TRANSPLANT SERVICE SCHEDULE 2 THE SERVICES A. SERVICE SPECIFICATIONS. Service Specification No.
A07/S/a NHS STANDARD CONTRACT FOR ADULT KIDNEY TRANSPLANT SERVICE SCHEDULE 2 THE SERVICES A. SERVICE SPECIFICATIONS Service Specification No. Service Commissioner Lead Provider Lead Period Date of Review
More informationKidney Transplant Education. For the Pretransplant Patient
Kidney Transplant Education For the Pretransplant Patient Indiana University Health University Hospital Welcome Welcome to Indiana University Health Transplant. We have partnered with Indiana University
More informationPatients as Partners. Kidney Care in a Holistic Perspective
Patients as Partners Kidney Care in a Holistic Perspective All of me All the time All the way Holistic approach Prevention Detection Slowing of progression Replacement Rehabilitation Chronic Kidney Disease
More informationJohn Sharp, MSSA, PMP Manager, Research Informatics Quantitative Health Sciences Cleveland Clinic, Cleveland, Ohio
John Sharp, MSSA, PMP Manager, Research Informatics Quantitative Health Sciences Cleveland Clinic, Cleveland, Ohio Co-Director BiomedicalResearch Informatics Clinical and Translational Science Consortium
More informationWhat is Health Ethics?
What is Health Ethics? By: Tory Fehrenbacher and Meredith Marston 1. 2. 3. Why is stem cell research ethical? Why is organ donation ethical? Health Ethics: A set of moral principles, beliefs and values
More information2/20/2015. Cardiac Evaluation of Potential Solid Organ Transplant Recipients. Issues Specific to Transplantation. Kidney Transplantation.
DISCLOSURES I have no relevant financial relationships to disclose. Cardiac Evaluation of Potential Solid Organ Transplant Recipients Michele Hamilton, MD Director, Heart Failure Program Cedars Sinai Heart
More informationChart 11-1. Number of dialysis facilities is growing, and share of for-profit and freestanding dialysis providers is increasing
11 0 Chart 11-1. Number of dialysis facilities is growing, and share of for-profit and freestanding dialysis providers is increasing Average annual percent change 2014 2009 2014 2013 2014 Total number
More informationThe Burden Of Diabetes And The Promise Of Biomedical Research
The Burden Of Diabetes And The Promise Of Biomedical Research Presented by John Anderson, MD Incoming Chair, ADA s National Advocacy Committee; Frist Clinic, Nashville, TN Type 1 Diabetes Usually diagnosed
More informationEmory Transplant Center
Emory Transplant Center MAKING A DIFFERENCE IN THE LIVES OF OUR PATIENTS AND OUR COMMUNITY Your Kidney and/or Pancreas Transplant AT EMORY UNIVERSITY HOSPITAL A Journey for Life Table of Contents 2 THE
More informationKidney and Pancreas Transplant Evaluation Clinics and Committee: Inpatient Nephrology Transplant Consult Service
Care of Renal Transplant Patients takes place in five distinct practice settings at the University of Michigan: a) Kidney and Pancreas Pre-transplant evaluation clinics (five half-day clinics per week)
More informationEnd Stage Renal Disease (ESRD)
End Stage Renal Disease (ESRD) AN OVERVIEW OF ESRD, TREATMENT COSTS & COVERAGE WSHIP Board Meeting January 14, 2015 Lisa Matthews and Sharon Becker 1 Kidney Disease Facts & Figures 1 in 10 people have
More informationCanadian Organ Replacement Register Annual Report: Treatment of End-Stage Organ Failure in Canada, 2003 to 2012
Canadian Organ Replacement Register Annual Report: Treatment of End-Stage Organ Failure in Canada, 2003 to 2012 Types of Care Our Vision Better data. Better decisions. Healthier Canadians. Our Mandate
More informationUCSF Kidney Transplant Symposium 2012
UCSF Kidney Transplant Symposium 2012 Nutrition Fitness in Kidney Transplant Mary Ellen DiPaola, RD, CDE UCSF Outpatient Dietitian Goal of Nutrition Fitness for Transplant Nutritional guidance of pre-
More informationComparison of the long-term outcomes of kidney transplantation: USA versus Spain
Nephrol Dial Transplant (2013) 28: 213 220 doi: 10.1093/ndt/gfs287 Advance Access publication 2 July 2012 Original Articles Comparison of the long-term outcomes of kidney transplantation: USA versus Spain
More informationEUROCORD. in 49 countries and 484 transplant centres* 264 EBMT 4847 (73%) cases 220 Non-EBMT 1797 (27%) cases
! 21%! EUROCORD 6756 cord blood transplantations performed from 1988 to March 2010 in 49 countries and 484 transplant centres* 264 EBMT 4847 (73%) cases 220 Non-EBMT 1797 (27%) cases * missing center
More informationJune 2016. Introduction
News from Scandiatransplant office June 2016 Introduction Main topics in this newsletter Updates in existing modules + Guidelines on infectious diseases + Information on urgent patients - Updates in existing
More informationEstimated GFR Based on Creatinine and Cystatin C
Estimated GFR Based on Creatinine and Cystatin C Lesley A Stevens, MD, MS Tufts Medical Center, Tufts University School of Medicine Boston MA Chronic Kidney Disease-Epidemiology Collaboration UO1 DK 053869,
More informationWake Forest School of Medicine Department of General Surgery
Wake Forest School of Medicine Department of General Surgery TRANSPLANT SURGERY RESIDENT CURRICULUM (PGY-3) OVERVIEW This curriculum has largely been adapted from the curriculum for transplant surgery
More informationModifications to How New Donor Information Received Post-Transplant is Reported to Recipient Centers
Modifications to How New Donor Information Received Post-Transplant is Reported to Recipient Centers Sponsoring Committee Ad Hoc Disease Transmission Advisory Public Comment: 2016-January Board Date: 2016-June
More informationPrognostic impact of uric acid in patients with stable coronary artery disease
Prognostic impact of uric acid in patients with stable coronary artery disease Gjin Ndrepepa, Siegmund Braun, Martin Hadamitzky, Massimiliano Fusaro, Hans-Ullrich Haase, Kathrin A. Birkmeier, Albert Schomig,
More informationWilliam B. Schwartz Division of Nephrology Fellowship Training Program Curriculum
William B. Schwartz Division of Nephrology Fellowship Training Program Curriculum Consult/Transplant Servic Patient Care Take medical history Perform physical examination Urinalysis and sediment eval Interpret
More informationKidney Transplantation
Kovler Organ Transplantation Center Kidney Transplantation A Patient Handbook Welcome Welcome to the Kidney Transplant Program at Northwestern Memorial Hospital. A kidney transplant can help make patients
More informationFacts for the Kidney Donor: Information to Consider
Clinical Transplant Services Kidney/Pancreas Transplant Program Mail Code: CB569 3181 SW Sam Jackson Park Rd. Portland, OR 97239-3098 Tel: 503/494-8500 Toll free: 800/452-1369 x 8500 Fax: 503/494-4492
More informationFAQ s ABOUT THE ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK (OPTN) KIDNEY PAIRED DONATION PILOT PROGRAM
FAQ s ABOUT THE ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK (OPTN) KIDNEY PAIRED DONATION PILOT PROGRAM What is Kidney Paired Donation? Kidney paired donation (KPD) helps donors who are medically able,
More informationRenal Disease in Type 2 Diabetes Mellitus
Renal Disease in Type 2 Diabetes Mellitus 6th Collaborative DiGP/HSE/UCC Conference 25 th September 2013 Dr. Eoin O Sullivan Consultant Endocrinologist Bon Secours Hospital Cork Case 69 year old woman
More informationArecent Institute of Medicine report titled Best care
Original Clinical ScienceçGeneral Variation in Cost and Quality in Kidney Transplantation Bishara A. Nassir, MD, 1 Carl E. Dean, MD, 2 Suying Li, PhD, 3 Nicholas Salkowski, PhD, 4 Craig A. Solid, PhD,
More informationFamily History and Diabetes. Practical Genomics for the Public Health Professional
Family History and Diabetes Practical Genomics for the Public Health Professional Outline Overview of Type 2 Diabetes/Gestational Diabetes Familial/Genetic Nature of Diabetes Interaction of Genes and Environment
More informationDonation & Transplantation
Donation & Transplantation Among Undocumented Immigrants Robin Worker L.C.S.W., Psy.D. University of California Irvine Medical Center Division of Kidney & Pancreas Transplantation The Human Face of an
More informationFAQ. The Kidney Project
The Kidney Project FAQ Frequently asked questions sourced from and designed for patients living with end stage renal disease (ESRD) answered by Dr. Shuvo Roy and Dr. William Fissell. kidney.ucsf.edu kidneyproject@ucsf.edu
More informationSt Lucia Diabetes and Hypertension Screening and Disease Management Programs
St Lucia Diabetes and Hypertension Screening and Disease Management Programs Michael Graven, MD, MSc,, MPH, FAAP Health Informatics and Neonatal Pediatrics Dalhousie University Halifax, Nova Scotia CANADA
More informationKIDNEY TRANSPLANTATION
KIDNEY TRANSPLANTATION Introduction Welcome to the Kidney Transplantation Program at Duke University Medical Center. This booklet will give you some information about kidney and pancreas transplantation.
More informationNBTA report on Black, Asian and Minority Ethnic Organ Donation and Transplantation data
NBTA report on Black, Asian and Minority Ethnic Organ Donation and Transplantation data July 0 Contents Page Supported by the Department of Health INTRODUCTION ORGAN DONOR REGISTER (ODR) DECEASED ORGAN
More informationKidney Pre-Transplant Patient Education Handbook. Charles O. Strickler Transplant Center
Kidney Pre-Transplant Patient Education Handbook Charles O. Strickler Transplant Center Kidney Pre-Transplant Patient Education Handbook Charles O. Strickler Transplant Center Kidney Transplant Program
More informationKIDNEY TRANSPLANTATION. The Most Commonly Asked Questions About Transplantation
Chapter 12 KIDNEY TRANSPLANTATION A Guide for Patients Brigham & Women s Hospital Kidney Transplant Staff * The Most Commonly Asked Questions About Transplantation What is a kidney transplant? A kidney
More informationREHABILITATION AND SOCIAL ASPECTS IN HOLISTIC APPROACH OF CKD PATIENTS
REHABILITATION AND SOCIAL ASPECTS IN HOLISTIC APPROACH OF CKD PATIENTS 2 0 T H B U D A P E S T N E P H R O L O G Y S C H O O L Á G N E S H A R I S, K Á L M Á N P O L N E R HOW MUCH TROUBLE A CHRONIC DISESASE
More informationSelection of the Optimal Umbilical Cord Blood Unit
Karen Ballen, MD Selection of the Optimal Umbilical Cord Blood Unit Massachusetts General Hospital September, 2013 OUTLINE Cell Dose HLA Match Allele Level HLA C KIR Directional Mismatch NIMA HLA Antibodies
More informationValue and Outcome Measurement in Health Care Delivery
Value and Outcome Measurement in Health Care Delivery Grecia Hospital, Costa Rica March 2014 Profs. Elizabeth Teisberg and Scott Wallace The Geisel School of Medicine at Dartmouth Health Care s Challenges
More informationMEDICAL POLICY. POLICY NUMBER: 7.02.01 CATEGORY: Transplants
MEDICAL POLICY SUBJECT: PANCREAS TRANSPLANT: (PANCREAS PANCREAS KIDNEY TRANSPLANT); ISLET PAGE: 1 OF: 8 If the member's subscriber contract excludes coverage for a specific service it is not covered under
More informationOrgan and Tissue Donation: An Overview
Organ and Tissue Donation: An Overview E-learning module revised by LifeSource, 2012 This learning module is part of a series of e-learning modules designed to meet hospital education requirements for
More informationTYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY. Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU
TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU Objectives: 1. To discuss epidemiology and presentation
More informationThe Cross-Sectional Study:
The Cross-Sectional Study: Investigating Prevalence and Association Ronald A. Thisted Departments of Health Studies and Statistics The University of Chicago CRTP Track I Seminar, Autumn, 2006 Lecture Objectives
More informationNierfunctiemeting en follow-up van chronisch nierlijden
Nierfunctiemeting en follow-up van chronisch nierlijden 12 Jan 2016 Patrick Peeters, M.D. Dept Nephrology Ghent University Hospital Plan of presentation 1/ Renal function determination: Measured GFR Estimated
More informationThe sensitive marker for glomerular filtration rate (GFR) Estimation of GFR from Serum Cystatin C:
The sensitive marker for glomerular filtration rate (GFR) Estimation of GFR from Serum Cystatin C: The good correlation allows close estimation of GFR Cystatin C GFR GFR in serum estimated* measured* n
More informationType 1 Diabetes ( Juvenile Diabetes)
Type 1 Diabetes W ( Juvenile Diabetes) hat is Type 1 Diabetes? Type 1 diabetes, also known as juvenile-onset diabetes, is one of the three main forms of diabetes affecting millions of people worldwide.
More informationKIDNEY PRE-TRANSPLANT EDUCATION BOOK
KIDNEY PRE-TRANSPLANT EDUCATION BOOK This book is to give information to you and your family about kidney transplant. Please keep this book handy in order to look back at it as you have questions. At the
More informationATTACHMENT I TO APPENDIX B OF UNOS BYLAWS
ATTACHMENT I TO APPENDIX B OF UNOS BYLAWS Designated Transplant Program Criteria XIII. Transplant Programs. A. In order to qualify for membership, a transplant program must utilize, for its histocompatibility
More informationWhere World-Class Expertise and Genuine Compassion Come Together. AT THE FOREFRONT OF TRANSPLANT CARE Kidney Combined Kidney-Pancreas Pancreas Islets
Where World-Class Expertise and Genuine Compassion Come Together 0011000110100111100110111100000101010011000101100010111000010010000100010000100001011110101010101111000 000010111000101110011000110100111100110111100000101010011000101100010111000010010000100010000100
More informationChronic Kidney Disease and the Electronic Health Record. Duaine Murphree, MD Sarah M. Thelen, MD
Chronic Kidney Disease and the Electronic Health Record Duaine Murphree, MD Sarah M. Thelen, MD Definition of Chronic Kidney Disease (CKD) Defined by the National Kidney Foundation Either a decline in
More informationYour Kidneys: Master Chemists of the Body
Your Kidneys: Master Chemists of the Body www.kidney.org National Kidney Foundation's Kidney Disease Outcomes Quality Initiative Did you know that the National Kidney Foundation's Kidney Disease Outcomes
More informationBACKGROUND. ADA and the European Association recently issued a consensus algorithm for management of type 2 diabetes
BACKGROUND More than 25% of people with diabetes take insulin ADA and the European Association recently issued a consensus algorithm for management of type 2 diabetes Insulin identified as the most effective
More informationDonating Life. The Workplace Partnership for Life Program
The Workplace Partnership for Life Program Every day about 63 people receive an organ transplant, but another 16 people on the waiting list die because not enough organs are available. Approximately 80,000
More informationDiabetic Nephropathy
Diabetic Nephropathy Kidney disease is common in people affected by diabetes mellitus Definition Urinary albumin excretion of more than 300mg in a 24 hour collection or macroalbuminuria Abnormal renal
More information10/31/2014. Much is unknown. What is npod? THE JDRF Network for the Pancreatic Organ Donor with Diabetes (npod):
THE JDRF Network for the Pancreatic Organ Donor with Diabetes (npod): a biobank and a collaborative project about the pathogenesis of type 1 diabetes Alberto Pugliese, MD 23 rd ADA Annual Conference on
More information