Once patients are activated and placed on the waiting list for a kidney, they start to accrue time toward receiving an organ. As with all transplant candidates, patients usually want to clearly understand how the list works.
So, the average wait time on the kidney list is about 3.5 years and is blood group dependent. (This means, for example, wait time for patients with bloodtype "A" is shortest, "AB" next shortest, then "B" and "O.")
Once an organ becomes available, the Transplant Resource Center (TRC) generates a computer list of patients awaiting kidney transplantation – this list is untouched by human hands; no preferences can be made as the list must be followed as it is printed. The coordinator will work her way down this list calling potential recipients to tell them about the donor history. If the recipient accepts the offer, the coordinator does a verbal assessment to update their medical record for any potential issues. Each center must choose 3-5 candidates per organ offer, depending on the number of kidneys available. Insurance is verified, current 30 day blood clots are used by the tissue typing lab do the final cross match, and the results are given to TRC. This crossmatch process can take anywhere from 4-8 hours depending on need for further testing based on initial results.
Once all crossmatch results are in, the organs are allocated based on which candidate has the first appropriate match. We usually call in two patients: an "heir" and a "spare". The heir is considered our first choice candidate based on the testing done. If there are any issues with the primary candidate (for example, an infection), TRC will go down the list to find the next acceptable candidate. So as not to add any extra "cold time" (time out of the body) to the organ, we will ask for the "spare" to come in so things can move more quickly.
This entire process can take anywhere from 4-12 hours from the time the initial call is made to the time of transplant. The kidney can be out of a body up to 40 hours, but the goal is to safely transplant as soon as possible.
-Rose Mary Gall, R.N., B.S., Kidney/Pancreas Transplant Coordinator
