While the organ waiting list in the US keeps growing, number of donors stays the same increasing the gap between recipients and donors. One of the ways to provide access to transplantation(txp) with less waiting time is the LD program. At UNC, Kidney LD evaluation (from first HLA Xmatch to donation) lasted 316±128 days for donors donated between 7/10-3/11. The program aimed at decreasing time to donation by removing obstacles in the process and streamlining the practice. We assumed this approach should increase number of LD txps.

Methods. A task group was formed and created a process map to review the process and to identify obstacles, delays and inconsistencies in donor evaluation process. Interventions have been implemented since 3/11: A streamlined FastTrack (FT) process was created. FT process was for selected donors with waitlist active recipients or donor and recipient pairs with none or little comorbidities. Weekly multidisciplinary LD meetings started. Donors had goal donation dates. A goal was set to have ≥1 scheduled LD txp/week.

Results. Since the implementation of the interventions in 3/11, there has been 56 LD txps at UNC. The time from first HLA Xmatch to donation decreased from 316±128 days to 227±87 days p<0.05. Out of 56 LD txps, 40 donors were enrolled in FT program. For 40 FT donors, time to donation decreased more:137±62 days p<0.001 Fig1. Another anticipated result was the increase of Kidney LD cases:volumes were 22 in 2010 and 25 in 2011, increased to 35 in 2012. UNC currently performs the highest percentage of Kidney LD txps in NC Fig2. Increased UNC LD cases resulted in increase in NC LD cases.

Conclusion. As a result of interventions the center increased number of LD kidney txps.Total volume of LD Kidney txps increased in the state of NC. Both the recipients and donors benefit from improved process.

« Back to 2013 American Transplant Congress