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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. back
to top
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 the Coalition
on Donation, promoting donation as a forthright, life-affirming
action. The Coalition 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. back to top
End-Stage Organ
Disease
A disease that leads to the permanent failure of an organ.
First Person
Consent Legislation
Legislation that allows donor designation to be indicated on a
driver's license or an official signed donor document, which gives
hospitals legal authority to proceed with organ procurement without
consent from the family.
High Blood
Pressure (hypertension) (HTN)
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.
back to top
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.
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. back
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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.
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. back
to top
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.
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. back
to top
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 follow-up regarding deceased organ donors. As
a resource to the community OPOs engage in public education on
the critical need for organ donation.
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 allocating 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. back
to top
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. back
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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. back
to top
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. back to top
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 and
- the transplant center's criteria for accepting
organ offers
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