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Dictionary Source:Organ Procurement and Transplantation Network -A-ABO Blood Type The classification of human blood into four groups: A, B, AB, and O. Auxiliary Transplant A type of liver transplant in which the patient's liver remains within the body, while another whole or partial liver is transplanted just beneath or adjacent to the recipient's. -C-Coalition on Donation A non-profit alliance of health and science professionals, transplant patients and voluntary health and transplant organizations. The national coalition works closely with local coalitions to increase public awareness of the critical organ shortage and create a greater willingness and commitment to organ and tissue donation (www.shareyourlife.org). Crossmatching A blood test done before the transplant to see if the potential recipient will react to the donor organ. If the crossmatch is "positive," then the donor and patient are incompatible. If the crossmatch is "negative," then the transplant may proceed. Crossmatching is routinely performed for kidney and pancreas transplants. -D-Deceased Donor Transplant The transplant of an organ from a deceased donor. Deceased Donor A person who has been declared "brain dead" and whose family has offered one or more organs or tissues to be used for transplantation. Department of Health and Human Services (HHS) This department of the federal government is responsible for health-related programs and issues (www.hhs.gov). Division of Transplantation (DoT) The office of the Federal government whose principal responsibilities include the management of the Organ Procurement and Transplantation Network (OPTN), the Scientific Registry of Transplant Recipients (SRTR) and the National Marrow Donor Program (NMDP) contracts; public education to increase organ/tissue donation; and technical assistance to organ procurement organizations (OPOs). See the DoT's Web site at www.hrsa.gov/osp/dot. Donor Someone from whom an organ or tissue is removed for transplantation. Donor Card A card, usually wallet sized, that indicates your wishes to be an organ donor. Donor Pool A group of people eligible to donate an organ. Durable Power of Attorney A legal document in which you may name someone to make medical decisions for you when you are unable to speak for yourself. -E-End Stage Organ Disease A disease that leads to the permanent failure of an organ and for which the patient requires dialysis or a transplant. End Stage Renal Disease (ESRD) Program Part of the Medicare program that provides medical coverage to people with end stage kidney disease or renal failure to help pay for dialysis or transplantation. End Stage Renal Disease/Chronic Kidney Failure (ESRD) A condition in which the kidneys no longer function and for which the patient requires dialysis or a transplant. -F-Final Rule 1999, Organ Procurement and Transplantation Network Final Rule (42 CFR Part 121) was issued and published in the Federal Register on April 2, 1998. This rule regulates the operation of the Organ Procurement and Transplantation Network, and includes amendments (resulting from the Institute of Medicine's report, Organ Procurement and Transplantation, 1999) that were issued and published in the Federal Register on October 20, 1999. The Final Rule went into effect on March 16, 2000 (U.S. Department of Health and Human Services, 1999). -H-Health and Human Services (HHS) This department of the federal government is responsible for health-related programs and issues (www.hhs.gov). See also Department of Health and Human Services. Health Care Financing Administration (HCFA) See Centers for Medicare & Medicaid Services (CMS) Health Resources and Services Administration (HRSA) Test HRSA, an agency of the United States Department of Health and Human Services, is charged with overseeing the Office of Special Programs, which in turn oversees the Division of Transplantation. HRSA helps provide health resources for medically under-served populations. HRSA supports a nationwide network of 643 community and migrant health centers, and 144 primary care programs for the homeless and residents of public housing, serving 8.1 million Americans each year. HRSA also works to build the health care workforce and maintains the National Health Service Corps, oversees the nation's organ transplantation system, works to decrease infant mortality and improve child health and provides services to people with AIDS through the Ryan White CARE Act programs. -I-Immunosuppression The act of artificially suppressing the immune response, usually through drugs, so that the body will not reject a transplanted organ or tissue. Drugs commonly used to suppress the immune system (immunosuppressives) after transplant include: prednisone, azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), OKT3 and ALG, mycophenolate mofetil (Cellcept) and tacrolimus (Prograf, FK506). Informed Consent The process of reaching an agreement based on a full disclosure and full understanding of what will take place. Informed consent has components of disclosure, comprehension, competence and voluntary response. Informed consent often refers to the process by which one makes decisions regarding medical procedures including the decision to donate the organs of a loved one. -K-Kidneys A pair of organs that remove wastes from your body through the production of urine. All of the blood in your body passes through the kidneys about 20 times every hour. Kidneys can be donated from living and cadaveric donors and transplanted into patients with kidney failure. -L-Liver The largest gland in your 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. The liver can be donated and transplanted. A living donor can give part of their liver, after which the liver will regenerate itself in both the donor and recipient. Living-Related Donor (LRD) A family member who donates a kidney, part of a lung, liver or pancreas to another family member. Examples: a brother and a sister, or a parent and a child. Living-Unrelated Donor A person who is not related by blood, who donates a kidney, part of a lung, liver or pancreas to another person (such as a husband, wife, friend or in-law. In the last few years, stranger-to-stranger living unrelated donations have greatly increased). -M-Marginal donor Donors that are not considered to be "ideal." Factors may include organs from non-heart beating cadaver donors, donor age greater than 55 years, prior infection with Hepatitis B or Hepatitis C and hypertension or diabetes mellitus. Match The compatibility between the donor and the recipient. The more appropriate the match, the greater the chance of a successful transplant. Medicaid A partnership between the Federal government and the individual states to share the cost of providing medical coverage for recipients of welfare programs and allowing states to provide the same coverage to low-income workers not eligible for welfare. Programs vary greatly from state to state. 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. Multiple Listing Being on the waiting list at more than one transplant center. -N-National Organ and Tissue Donor Awareness Week (NOTDAW) Congress has designated the third week of April each year since 1983 to recognize organ donors and their families and to promote organ donation. National Organ Transplant Act (NOTA) Passed by Congress in 1984, NOTA outlawed the sale of human organs and initiated the development of a national system for organ sharing and a scientific registry to collect and report transplant data. -O-OPO Local Area Each OPO provides its organ procurement services to the transplant programs in its area. An OPO's local service area can include a portion of a city, a portion of a state or an entire state. When an organ becomes available, the list of potential recipients is generated from the OPO's local service area. If a patient match is not made in that local area, a wider, regional list of patients waiting is generated. OPO Service Area Each OPO provides organ procurement services for transplant centers in a given area within the U.S. An OPO service area can include a portion of a city, a portion of a state, an entire state or several states. OPOs distribute organs according to an established allocation policy. 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, such as a kidney or a portion of the liver, lung, intestine to someone in need of that organ and/or to decide that at time of death, your family has permission to donate your healthy organs to people in need of them. Organ Preservation Donated organs require special methods of preservation to keep them viable between procurement and transplantation. Without preservation, the organ will deteriorate. The length of time organs and tissues can be kept outside the body vary depending on the organ, the type of preservation fluid, and the preservation method (pump or cold storage). Common preservation times vary from two to four hours for lungs to 48 hours for kidneys. Organ Procurement The removal or retrieval of organs 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. Members of the OPTN include transplant centers, Organ Procurement Organizations (OPOs), histocompatibility laboratories, voluntary healthcare organizations and the general public. The United Network for Organ Sharing (UNOS) operates the OPTN under contract with the Federal government. Organ Procurement Organization (OPO) 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 cadaveric organ donors. As a resource to the community OPOs engage in public education on the critical need for organ donation. Organdonor.gov A website created by the Health Resources and Services Administration (HRSA) and the Department of Health and Human Services (HHS) to provide information and resources on organ donation and transplantation issues. -P-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. -R-Rejection Rejection occurs when the body tries to attack a transplanted organ because it reacts to the organ or tissue as a foreign object and produces antibodies to destroy it. Anti-rejection (immunosuppressive) drugs help prevent rejection. Retransplantation Due to rejection or failure of a transplanted organ, some patients receive another transplant after having returned to the waiting list. -S-Scientific Registry of Transplant Recipients (SRTR) In 1987, Congress passed the National Organ Transplant Act that mandated the establishment of the Organ procurement and Transplantation Network and SRTR. The purpose of the SRTR is to provide ongoing research to evaluate information about donors, transplant candidates, and recipients, as well as patient and graft survival rates. University Renal Research and Education Association (URREA) operates the SRTR under contract with the Federal government. The SRTR contains historical data from October 1, 1987 to present. The registry also tracks all transplant patients from the time of transplant through hospital discharge, and then annually, until graft failure or death. -T-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. Transplant Center A medical institution within the United States that operates an organ transplant program. Transplant Program Components of a transplant center. An individual transplant center may have programs for the transplantation of hearts, lungs, liver, kidneys, pancreata, and/or intestine. Transplant, Transplantation To transfer a section of tissue or complete or partial organ from its original position to a new position. For instance, transferring a healthy organ from one person's body to a person in need of that organ. -U-U.S. Scientific Registry of Transplant Recipients (SRTR) A database of posttransplant information. Follow-up data on every transplant are used to track transplant center performance, transplant success rates and medical issues impacting transplant recipients. Under contract with the Health Resources and Services Administration (HRSA), UNOS facilitates the collection, tracking and reporting of transplant recipient and donor data. Uniform Anatomical Gift Act The 1968 Uniform Anatomical Gift Act (UAGA) provided the legal foundation upon which human organs and tissues could be donated for transplantation by execution of an anatomical gift authorizing document. Since 1972, all 50 States and the District of Columbia have adopted this Act, or forms of this Act. Uniform Determination of Death Act The 1981 Uniform Determination of Death Act is a model statute defining "brain death." Versions of this Act have been adopted in 39 states and the District of Columbia. The act states that an individual who has sustained either (a) irreversible cessation of circulatory or respiratory functions or (b) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards. United Network for Organ Sharing (UNOS) The transplant community is joined under a nationwide umbrella: The United Network for Organ Sharing (UNOS), a nonprofit charitable organization, administers and maintains the nation?s organ transplant waiting list under contract with the Health Resources and Services Administration of the U.S. Department of Health and Human Services. University Renal Research and Education Association (URREA) A nonprofit organization established for the purpose of conducting clinical and economic studies. It administers the Scientific Registry of Transplant Recipients (SRTR) under contract with the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). -W-Waiting List (waiting pool) After evaluation by the transplant physician, a patient is added to the national waiting list by the transplant center. Lists are specific to both geographic area and organ type (heart, lung, kidney, liver, pancreas, intestine, heart-lung, or kidney-pancreas). Each time a donor organ becomes available, the UNOS computer generates a list of potential recipients based on factors that include genetic similarity, blood type, organ size, medical urgency and time on the waiting list. Through this process, a "new" list is generated each time an organ becomes available that best "matches" a patient to a donated organ. Waiting Period A period of time when you are not covered by insurance for a particular problem, such as a pre-existing condition. -X-Xenotransplantation Transplantation of an animal organ into a human. Although xenotransplantation is highly experimental, many scientists view it as an eventual solution to the shortage of human organs. |
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