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    Learning More About Kidney Transplant Wait Times

    Listing Process and Kidney Acceptance Criteria Impact Wait for Kidney

    by William Bry, M.D., surgical director, Kidney Transplant Program, and Laura Miyashita

    Individuals in Northern California seeking a kidney transplant from a deceased donor typically have a four to seven year wait. Nationwide, this time varies based on the regional balance between the number of organ donors and candidates awaiting transplant.

    Unfortunately, California has some of the longest waiting times in the U.S. The state's population and the number of individuals in California needing a transplant both contribute to this statistic. Other factors contributing to one's transplant wait time include:

    • Blood type

    • High PRA

    • Organ procurement organization (OPO) in which one is listed

    • Transplant center at which one is listed, and how the center's listing process works.
    "Most of Northern California is served by the OPO California Transplant Donor Network (CTDN)," says William Bry, M.D., surgical director of California Pacific Medical Center's Kidney Transplant Program. CTDN's team works closely with hospitals throughout Northern California to ensure every family gets the opportunity to say "Yes" to donation.

    Navigating the Listing Process

    As a kidney transplant candidate, it is important to understand your transplant center's listing process and kidney acceptance criteria as they directly affect one's wait for a transplant.

    "After the initial kidney transplant evaluation, most patients require lengthy and time-consuming evaluations like heart studies, colonoscopies, mammograms and vascular tests before they can receive a transplant," explains Bry. "Some transplant centers take 6-12 months to put a transplant candidate's name on the UNOS national kidney transplant wait list because they wait until all these tests are complete."

    At California Pacific Medical Center (CPMC) in San Francisco, the kidney team lists qualified kidney transplant candidates about one month following kidney transplant evaluation. "Our goal is to get candidates onto the United Network for Organ Sharing (UNOS) transplant waiting list as quickly as possible so they can quickly begin accumulating wait time," explains Bry. The Kidney Team processes the basic blood tests and other essential paperwork needed for listing within about one month. Then, after a candidate is listed, the Kidney Team works with him/her to ensure completion of the necessary, but more time-consuming, health studies.

    Kidney Acceptance Criteria

    "At CPMC, we try to accept every possible kidney offered to our candidates by CTDN, the OPO that serves our transplant center," says Bry. "We carefully evaluate the donor's medical and social history as well as lab tests, X-ray studies and sometimes biopsy data.

    Ultimately, this aggressive stance enables us to successfully transplant some kidneys declined by other transplant centers - with excellent outcomes."

    According to the government agency that monitors all transplant programs (Scientific Registry of Transplant Recipients), California Pacific Medical Center is the only California kidney transplant center with higher than expected outcomes for both 1- and 3-year patient survival. Additionally, California Pacific performs more expanded criteria donor (ECD) kidney transplants than any other Northern California transplant center.

    http://www.srtr.org/csr/current/Centers/TransplantCenters_New201106x.aspx?organcode=KI
    Accessed September 29, 2011

    Kidney Transplant Process

    CPMC:

    1. Initial Transplant Evaluation

    2. List with UNOS

    3. Wait for Kidney starts here

    4. Complete needed tests & evaluations while waiting for kidney

    Some Hospitals
    1. Initial Transplant Evaluation

    2. Complete needed tests & evaluations before waiting for kidney

    3. List with UNOS

    4. Wait for Kidney starts here

    Your wait for a kidney officially starts when you are listed with UNOS.

    It is important to understand your transplant center’s listing process, as the length of time it takes to put your name on the national transplant wait list may vary by center.






    article published in Fall / Winter 2011Kidney Review newsletter