Glossary

Brain Death - Irreversible cessation of cerebral and brain stem function; characterized by absence of electrical activity in the brain, blood flow to the brain, and brain function as determined by clinical assessment of responses. A brain dead person is dead, although his or her cardiopulmonary functioning may be artificially maintained for some time.



Donation after Cardiac Death (DCD) - Recovery of organs and or tissues from a donor whose heart has irreversibly stopped beating, previously referred to as non-heart-beating or asystolic donation.



Eligible Death - Although it is recognized that this definition does not include all potential donors, for reporting purposes for DSA performance assessment, an eligible death for organ donation is defined as the death of a patient 70 years old or younger who ultimately is legally declared brain dead according to hospital policy, and: independent of family decision regarding donation or availability of next-of-kin; independent of medical examiner or coroner involvement in the case; independent of local acceptance criteria or transplant center practice; and who exhibits none of the following :
  • Active infections (specific diagnoses) [Exclusions to the Definition of Eligible] :
    -Bacterial: Tuberculosis; Gangrenous bowel or perforated bowel and/or intra-abdominal sepsis; see sepsis below under General.
    -Viral: HIV infection by serologic or molecular detection; Rabies; Reactive Hepatitis B Surface Antigen; Retroviral infections including HTLV I/II; Viral Encephalitis or Meningitis; Active Herpes simplex, varicella zoster, or cytomegalovirus viremia or pneumonia; Acute Epstein Barr Virus (mononucleosis); West Nile Virus infection; SARS.
    -Fungal: Active infection with Cryptococcus, Aspergillus, Histoplasma, Coccidioides; Active candidemia or invasive yeast infection.
    -Parasites: Active infection with Trypanosoma cruzi (Chagas'), Leishmania, Strongyloides, or Malaria (Plasmodium sp.).
    - Prion: Creutzfeldt-Jacob Disease.
  • General [Exclusions to the Definition of Eligible] :
    -Aplastic Anemia; Agranulocytosis; Extreme Immaturity (<500 grams or gestational age of <32 weeks); Current malignant neoplasms except non-melanoma skin cancers such as basal cell and squamous cell cancer and primary CNS tumors without evident metastatic disease ; Previous malignant neoplasms with current evident metastatic disease; A history of melanoma; Hematologic malignancies - Leukemia, Hodgkin's Disease, Lymphoma, Multiple Myeloma; Multi-system organ failure (MSOF) due to overwhelming sepsis or MSOF without sepsis defined as 3 or more systems in simultaneous failure for a period of 24 hours or more without response to treatment or resuscitation; Active Fungal, Parasitic, Viral, or Bacterial Meningitis or encephalitis.



Expanded Criteria Donor (ECD) Kidney - A brain dead donor over the age of 60 years; or from a donor over the age of 50 years with two of the following: a history of hypertension, the most recent serum creatinine greater than or equal to 1.5 mg/dl, or death resulting from a cerebral vascular accident (stroke). This definition applies to the allocation of deceased donor kidneys.



Standard Criteria Donor (SCD) - A donor who does not meet the criteria for DCD or ECD.



Wait List (WL) - The list of candidates registered to receive organ transplants. When a donor organ becomes available, the matching system generates a new, more specific list of potential recipients based on the criteria defined in that organ's allocation policy (e.g., organ type, geographic local and regional area, genetic compatibility measures, details about the condition of the organ, the candidate's disease severity, time spent waiting, etc.).
Wait List Registration

To be registered for a transplant, a patient undergoes a complete clinical evaluation by the transplant team. If a transplant is needed, the center registers that patient on the Wait List. Within ten days of evaluating a patient for transplant, the transplant center is required to send a letter informing the patient that he or she has or has not been registered on the Wait List. The following registration status categories are used to track waiting patients:
  • Active, describing actively waiting patients whose conditions are favorable for transplant surgery;
  • Inactive, describing patients experiencing conditions (e.g., infection) that temporarily rule out transplant surgery;
  • Removal, describing patients removed from the Wait List a) by personal, voluntary choice, b) because they have become too ill to survive surgery or posttransplant immunosuppression, c) are recovering adequate organ function, d) have received a transplant, or e) have died.



Waiting Time
- The amount of time a candidate is on the Wait List. Waiting times can be influenced by many factors, including:
  • blood type (some are rarer than others)
  • tissue type
  • height and weight of transplant candidate
  • size of donated organ
  • medical urgency
  • time on the waiting list
  • the distance between the donor's hospital and the potential donor organ
  • how many donors there are in the local area over a period of time and
  • the transplant center's criteria for accepting organ offers
    Depending on the kind of organ needed, some factors are more important than others.





* This glossary was adapted from the Organ Procurement and Transplant Network (OPTN).  For a more complete list of donation-related terminology please refer to the following link: http://optn.transplant.hrsa.gov/resources/glossary.asp
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