Friday, July 19, 2013

TRANSPLANT JARGON EXPLAINED

A GLOSSARY OF TRANSPLANT TERMINOLOGY

  • allocation - algorithm for distribution of a deceased donor organ
  • allograft - a donor organ from a non-identical member of the same species (e.g., parent to child)
  • autograft - a donor organ from a genetically identical member of the same species (e.g., between clones or identical twins)
  • cold ischemia - time between cessation of blood flow to the donor organ and restoration of blood flow during transplantation
  • en bloc - organs that remain anatomically connected (e.g., 2 pediatric kidneys still attached to the aorta and vena cava)
  • DCD - Donor after Circulatory Death is a deceased organ donor whose death was declared based on cessation of cardiac activity
  • deceased donor - a human being whose organs have been removed after death for the purpose of transplantation
  • delayed graft function (DGF) - a newly transplanted organ that is alive (receiving blood flow) but has not yet begun to function (e.g., a transplanted kidney that is not yet making urine)
  • donor service area (DSA) - the geographic region that is the smallest unit of organ allocation and is served by one OPO
  • EPTS (estimated post transplant survival) - a formula based on four medical factors about the transplant candidate (age, time on dialysis, presence of diabetes, history of a prior transplant) that determines the statistical likelihood of survival of a patient in comparison to other patients 
  • expanded criteria donor (ECD) - a deceased organ donor who meets the UNOS definition of a less than optimal donor because of age, cause of death or medical history. In general, these organs are more vulnerable to all types of transplant related injury than standard criteria organs.
  • graft - organ +/- tissue that is transplanted
  • KDPI - kidney donor profile index is a numerical measure that combines ten dimensions of information about a donor, including clinical information and demographics, to express the quality of the donor kidney relative to other donors.(optn KDPI source info). Ranging from 1-100%, a value of 75% means that this kidney has a relative risk of failing that is higher than 75% of deceased donor kidneys.
  • immunosuppression - pharmacologic or biologic therapy administered to diminish the strength of the response of the immune system
  • import - an organ that has been recovered in a different UNOS region or DSA and transported in to the transplant center and patient. Importanting an organ prolongs the cold ischemia period.
  • LYFT (life years from transplant) - the statistical quality adjusted survival benefit provided by the transplantation of a given organ to a given recipient
  • multi-visceral - a transplant in which more than one abdominal organ is transplanted, usually involving the liver +/- pancreas, duodenum, stomach, small intestine
  • NOTA (National Organ Transplant Act) - federal legislation, P.L. 98-507,  enacted in 1984 to address the organ donation shortage and to improve organ matching and placement. The act and its amendments establish the national registry for organ matching and call for a transplant network to be operated by a non-profit organization under federal contract.
  • opo (organ procurement organization) - a private, non-profit organization responsible for increasing donor registration in the assigned donor service area and for coordinating the donation process in the service area hospitals.
  • OPTN (organ procurement and transplantation network) - established by the U.S. congress when it enacted the National Organ Transplant Act (NOTA), this is a unified transplant network to be operated by a private, non-profit organization under federal contract.
  • rejection - recognition and attack of the transplanted organ and tissue by the host's immune system
  • standard criteria donor (SCD) - a deceased organ donor who does not meet the UNOS definition of an expanded criteria donor. In general, these organs are most likely to function promptly after transplantation, and most likely to continue functioning for may years.
  • SRTR  (Scientific Registry of Transplant Recipients) - the primary source of transplant data in the U.S., containing information from 1988 and later. These data are developed from mandatory transplant center reports and are used by multiple regulatory agencies and researchers.
  • tolerance - a host's immune system's failure to recognize and respond to a specific donor's organ (or other stimulus) while retaining all other functions
  • Thrombosis - the condition of blood clot blocking flow through a blood vessel
  • UNOS (United Network for Organ Sharing) - the private, non-profit organization that manages the nation's organ transplant system under contract with the federal government.
  • VCA (vascularized composite allograft) -multiple tissues such as muscle, bone, nerve and skin that are transplanted as a functional unit and require the surgical attachment of blood vessels (e.g., a hand or face).
  • xenograft - a donor organ from a member of a different species (e.g., pig to human)
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