Kidney Paired Donation Candidate Registration

Data System for Organ Procurement and Transplantation Network

Kidney Paired Donation Candidate Registration_Instructions

Kidney Paired Donation Candidate Registration

OMB: 0915-0157

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Kidney Paired Donation Candidate Registration Field Descriptions



Add a KPD Candidate


Institution: Home transplant center: Transplant center name and center code. This field is required.


SSN: Candidate’s social security number. Numeric format XXXXXXXXX. This field is required.


Date of birth: MM/DD/YYYY format. This field is required.


Waitlist ID: Numeric format. This field is required. The candidate's Waitlist ID is located in WaitlistSM.



Candidate Summary Details Institution


Home transplant center: The center name and center code for the home transplant center displays. This field cannot be updated on this page. Home transplant center was entered when the candidate was added to KPD.


Candidate Summary Details Demographic Information


Last name: KPD candidate last name. This field is copied from the candidate’s WaitlistSM registration. This field is required for eligibility on the match run.


First name: KPD candidate first name. This field is copied from the candidate’s WaitlistSM registration. This field is required for eligibility on the match run.


Middle initial: KPD candidate middle initial. This field is copied from the candidate’s WaitlistSM registration.


SSN: KPD candidate's Social Security Number. This field is copied from the candidate’s WaitlistSM registration. Numeric format XXX-XX-XXXX. This field is required.


Date of birth: KPD candidate's date of birth. This field is copied from the candidate’s WaitlistSM registration. Date: MM/DD/YYYY format. This field is required.


Current age: KPD candidate's current age. The KPD candidate's current age is calculated based on the date of birth and today's date. This field cannot be updated on this page.


Note: For pediatric candidates, the current age is calculated based on the date of birth and the date the candidate was added to the KPD system. The current age displayed is the candidate's age today.


Gender: KPD candidate gender. This field is copied from the candidate’s WaitlistSM registration. (Values: Male, Female). This field is required for eligibility on the match run.


Center's patient ID: KPD candidate’s patient ID at listing center. This field is copied from the candidate’s WaitlistSM registration.

State of permanent residence: KPD candidate’s permanent state of residence. This field is copied from the candidate’s WaitlistSM registration.


Permanent zip code: KPD candidate permanent zip code. This field is copied from the candidate’s WaitlistSM registration. Numeric format XXXXX or XXXXX-XXXX.


Candidate Summary Details Demographic Information


Ethnicity/race: If the KPD candidate has an existing record in WaitlistSM, the KPD candidate's ethnicity or race is copied from WaitlistSM. This field is required for eligibility on the match run.


Values:

American Indian or Alaska Native: Values: American Indian, Eskimo, Aleutian, Alaska Indian, American Indian or Alaska Native: Other, American Indian or Alaska Native: Not Specified/Unknown

 

Asian: Values: Asian Indian/Indian Sub-Continent, Chinese, Filipino, Japanese, Korean, Vietnamese, Asian: Other, Asian: Not Specified/Unknown

Black or African American: Values: African American, African (Continental), West Indian, Haitian, Black or African American: Other, Black or African American: Not Specified/Unknown.

Hispanic/Latino: Values: Mexican, Puerto Rican (Mainland), Puerto Rican (Island), Cuban, Hispanic/Latino: Other, Hispanic/Latino: Not Specified/Unknown.

 

Native Hawaiian or Other Pacific Islander: Values: Native Hawaiian, Guamanian or Chamorro, Samoan, Native Hawaiian or Other Pacific Islander: Other, Native Hawaiian or Other Pacific Islander: Not Specified/Unknown.


White: Values: European Descent, Arab or Middle Eastern, North African (non-Black), White: Other, White: Not Specified/Unknown.



Candidate Details Clinical Information


ABO: If the KPD candidate has an existing record in WaitlistSM, the KPD candidate's ABO blood type is copied from WaitlistSM. Otherwise, select the KPD candidate's blood type from the available choices. A2 is used as shorthand for any blood type A subtype other than A1 (i.e. non-A1, negative for A1). A2B is used as shorthand for any blood type AB subtype other than A1B (i.e. non-A1B, negative for A1B). This field is required for eligibility on the match run. Once the ABO has been verified by a second user, this field cannot be updated.


Note: If the second user only verifies the "primary" blood type, the sub-types can be updated. Once the subtypes have been entered, the ABO blood type can no longer be updated.


Height: If the KPD candidate has an existing record in WaitlistSM, the candidate's height in feet and inches is copied from WaitlistSM. Otherwise, enter the KPD candidate's height in feet and inches. The height also displays in centimeters.


Weight: If the KPD candidate has an existing record in WaitlistSM, the candidate's weight in kilograms is copied from WaitlistSM. Otherwise, enter the KPD candidate's weight in kilograms. The weight also displays in pounds.


BMI: Body Mass Index is a measure that adjusts body weight for height. The BMI is calculated by the system and is based on the ratio of the weight of the body in kilograms to the square of its height in meters. This field cannot be updated.


CPRA: Calculated Panel Reactive Antibody (CPRA). CPRA is calculated by the system using A, B, Bw4, Bw6, C, DR, DR 51, DR52 and DQB1 unacceptable antigens entered for the candidate.


The KPD candidate's CPRA display is based on information entered in WaitlistSM. This field cannot be updated. This field is required for eligibility on the match run.


Is candidate currently on dialysis?: (Values: Yes, No). The answer to this question displays based on information entered in WaitlistSM. This field cannot be updated.


Dialysis date: The dialysis date displays based on information entered in WaitlistSM. This field cannot be updated.



Candidate Details KPD Information


Has the candidate signed the Agreement to participate in the KPD Pilot Program?: (Values: Yes, No). This field is required for eligibility on the match run.


Has the candidate signed to release protected health information so that medical information may be shared with other transplant hospitals?: (Values: Yes, No). This field is required for eligibility on the match run.


Is the candidate a prior living donor?: (Values: Yes, No). This field is required for eligibility on the match run.


KPD waiting time start date: The date the candidate was added to the KPD system displays. Date: MM/DD/YYYY format. This field cannot be updated on this page.


Is the candidate considered a pediatric candidate in the KPD system?: The answer displays based on the candidate's date of birth. (Values: Yes, No). This field cannot be updated on this page. If the candidate was added to the KPD system prior to their eighteenth birthday, the candidate is considered a pediatric candidate.


Orphaned candidate: (Values: Yes, No). This field cannot be updated and is set by a KPD Administrator.


Note: An orphaned candidate is a KPD candidate who does not receive a kidney transplant from the matched donor for any reason after the candidate's paired donor has donated.


KPD status: (Values: Active, Inactive, Removed). This field is required for eligibility on the match run.



Candidate Details KPD Information


Inactive reason: If Inactive is selected for KPD status, the Inactive reason field is required:


  • Candidate Choice: Candidate temporarily inactive due to candidate choice

  • Temporary Ineligibility: Candidate currently ineligible for OPTN KPD Pilot Program (e.g., incomplete data, not on deceased donor waiting list, etc.)

  • Donor Inactive: Candidate is temporarily inactive because donor is temporarily inactive

  • Insurance Issues: Candidate temporarily inactive due to insurance issues

  • Medical Non-Compliance: Candidate temporarily inactive due to medical non-compliance

  • Operational issues: Candidate temporarily inactive due to operational issues (e.g., physician/surgeon unavailable, heavy workload at center, etc.

  • Temporarily Too Sick: Candidate temporarily inactive because too sick

  • Temporarily Too Well: Candidate temporarily inactive because too well

  • Transplant Pending: OPTN KPD Pilot Program exchange pending

  • Transplant Pending: Other KPD program exchange pending

  • Transplant Pending: Non-KPD transplant pending

  • Other, specify



Other, Specify: If the inactive reason is set to Other, the Specify field is required. Range 1-100 characters.


Removal reason: If the KPD status is set to Removed, the Removal reason is required.


  • Removed: Candidate chose to withdraw from OPTN KPD Pilot Program

  • Removed: Candidate removed because paired donor removed from OPTN KPD Pilot Program

  • Removed: Candidate unable to complete work-up

  • Removed: Candidate not suitable according to program criteria

  • Removed: Candidate too sick

  • Removed: Candidate too well

  • Removed: Candidate expired

  • Removed: Candidate added in error

  • Removed: Candidate transferred to another center

  • Transplanted: Received transplant through OPTN KPD Pilot Program

  • Transplanted: Received transplant through other KPD program

  • Transplanted: Received other living donor transplant (non-KPD)

  • Transplanted: Received deceased donor transplant

  • Other, specify



Other, Specify: If the removal reason is set to Other, the Specify field is required. Range 1-100 characters.



Candidate Details Comments


Comments: Alphanumeric field. Range 1- 2000 characters.



Candidate Choices

The Candidate Choices tab contains all of the options available to the candidate for determining if the candidate would be willing to accept a donor's kidney prior to the match.



Candidate Choices Institution


Home transplant center: The center code for the home transplant center displays. This field cannot be updated on this page.



Candidate Choices KPD Candidate Choices


Candidate willing to travel?: (Values: Yes, No). This field is required for eligibility on the match run.


If so, to which center(s) is the candidate willing to travel?: This field is required if Candidate willing to travel field is set to Yes. Available options will be shown on the screen. Selections or removals can be made by using “add” or “remove” buttons.


Would candidate be willing to travel further if funding were provided?: (Values: Yes, No).


Will candidate accept a shipped kidney?: (Values: Yes, No). This field is required for eligibility on the match run. Available options will be shown in the screen. Selections or removals can be made by using “add” or “remove” buttons.


If yes, from which centers is the candidate willing to accept a shipped kidney?: This field is required if Will candidate accept a shipped kidney field is set to Yes.


Minimum acceptable donor age: Whole number between 18-99. This field is required for eligibility on the match run.


Maximum acceptable donor age: Whole number between 18 and 99. This field is required for eligibility on the match run.


Minimum acceptable donor BMI: Whole number between 15 and 50. This field is required for eligibility on the match run.


Minimum acceptable donor creatinine clearance (24-hour urine collection) or donor GFR (isotopic method): Whole number between 50 and 200. This field is required for eligibility on the match run.


Maximum acceptable donor blood pressure – systolic (average): Whole number between 50 and 300. This field is required for eligibility on the match run.


Maximum acceptable donor blood pressure - diastolic (average): Whole number between 40 and 200. This field is required for eligibility on the match run.



Candidate willing to accept a donor who is Hep B core antibody positive?:* *Assumes donor is Hep B surface antigen negative: (Values: Yes, No). This field is required for eligibility on the match run.


Candidate willing to accept a CMV positive donor?: (Values: Yes, No). This field is required for eligibility on the match run.


Candidate willing to accept an EBV positive donor?: (Values: Yes, No). This field is required for eligibility on the match run.


Candidate willing to accept only left kidney, only right kidney, or either kidney?: (Values: Right kidney, Left kidney, Either kidney). This field is required for eligibility on the match run.



HLA and Unacceptables

The HLA and Unacceptables tab contains all the KPD candidate's HLA information, as well as the antigens determined to be either unacceptable or all other antibody specificities.


HLA and Unacceptables Institution


Home transplant center: The center code for the home transplant center displays. This field cannot be updated on this page.



HLA and Unacceptables Class I


If unacceptable antigens are entered for the following (C, DR51, DR52, DR53, DQB1, DQA1, DPB1) then the corresponding HLA information is also required in order for the candidate to be eligible for KPD match runs.



A: Candidate A antigens. Values for both fields are required for eligibility on the match run.


B: Candidate B antigens. Values for both fields are required for eligibility on the match run.


BW4: Candidate BW4 antigens. This field is required for eligibility on the match run.


BW6: Candidate BW6 antigen. This field is required for eligibility on the match run.


C: Candidate C antigens. Values for both fields are required for eligibility on the match run when unacceptable are entered for C.



HLA and Unacceptables Class II


DR: Candidate DR antigen. Values for both fields are required for eligibility on the match run.


DR51: Candidate DR51 antigen. This field is required for eligibility on the match run if corresponding unacceptable antigens are reported.


DR52: Candidate DR52 antigen. This field is required for eligibility on the match run if corresponding unacceptable antigens are reported.


DR53: Candidate DR53 antigen from both drop-down lists. This field is required for eligibility on the match run if corresponding unacceptable antigens are reported.


DQB1: Candidate DQB1 antigens. Values for both fields are required for eligibility on the match run when unacceptable is entered for DQB1.


DQA1: Candidate DQA1 antigens. Values for both fields are required for eligibility on the match run when unacceptable is entered for DQA1.


DPB1: Candidate DPB1 antigens. Values for both fields are required for eligibility on the match run when unacceptable is entered for DPB1.



HLA and Unacceptables Testing and Review of Unacceptables


Note: Based upon policy, centers are required to retest antibodies for active candidates. The most recent antibody test date must be within the 110 days.


Tested for anti HLA antibodies: (Values: Yes, sensitized (antibodies detected)’ Yes, unsensitized (no antibodies detected); No, not tested). This field is required.


If yes, most recent antibody test date: Date: MM/DD/YYYY format. This field is required.


Prior to a candidate appearing on their first match run, all unacceptable antigens in KPD must be reviewed. Have all the candidate’s unacceptable antigens been reviewed?: (Values: Yes, No). A ‘Yes’ answer is required for eligibility on the match run.



HLA and Unacceptables - Unacceptable Antigens


CPRA value used for allocation per OPTN policy: Calculated by system using A, B, C, DR, BW, DR 51, DR 52, DR 53 and DQB1 unacceptable antigens entered for the candidate. This field cannot be updated on this screen.


Detailed CPRA value: Calculated by system using A, B, C, DR, BW, DR 51, DR 52, DR 53 and DQB1 unacceptable antigens entered for the candidate. This field cannot be updated on this screen.


Select all A unacceptable antigens: KPD candidate's A unacceptable antigens.


Select all B unacceptable antigens: KPD candidate's B unacceptable antigens.


Select BW unacceptable antigens: KPD candidate's BW unacceptable antigens.


Select all C unacceptable antigens: KPD candidate's C unacceptable antigens.



HLA and Unacceptables - Unacceptable Antigens


Select all DR unacceptable antigens: KPD candidate's DR unacceptable antigens.


Select all DR 51unacceptable antigens: KPD candidate's DR 51unacceptable antigens.


Select all DR 52 unacceptable antigens: KPD candidate's DR 52 unacceptable antigens.


Select all DR 53 unacceptable antigens: KPD candidate's DR 53 unacceptable antigens.



HLA and Unacceptables - Unacceptable Antigens



Select all DQB1 unacceptable antigens: KPD candidate's DQB1 unacceptable antigens.


Select all DQA1 unacceptable antigens: KPD candidate's DQA1 unacceptable antigens.


Select all DPB1 unacceptable antigens: KPD candidate's DPB1 unacceptable antigens.



HLA and Unacceptables All Other Antibody Specificities


Select all A other antibody specificities: KPD candidate's A other antibody specificities.


Select all B other antibody specificities: KPD candidate's B other antibody specificities.


Select BW other antibody specificities: KPD candidate's BW other antibody specificities.


Select all C other antibody specificities: KPD candidate's C other antibody specificities.



HLA and Unacceptables All Other Antibody Specificities


Select all DR other antibody specificities: KPD candidate’s DR other antibody specificities.


Select all DR 51other antibody specificities: KPD candidate's DR 51 other antibody specificities.


Select all DR 52 unacceptable antigens: KPD candidate's DR 52 unacceptable antigens.


Select all DR 53 unacceptable antigens: KPD candidate's DR 53 unacceptable antigens.


Select all DQB1 other antibody specificities: KPD candidate's DQB1 other antibody specificities.


Select all DQA1 other antibody specificities: KPD candidate's DQA1 other antibody specificities.


Select all DPB1 other antibody specificities: KPD candidate's DPB1 other antibody specificities.


Select all DPB1 other epitope specificities: KPD candidate's DPB1 other epitope specificities.



Titers


Note: The Titers tab only displays if the candidate has an ABO blood type of O or B. This tab contains all the data needed to determine if a candidate is eligible to receive a transplant from an A2 or A2B donor.



Titers Institution


Home transplant center: The center code for the home transplant center displays. This field cannot be updated on this page.



Titers - Titer Information

If the candidate blood type is B, this section displays:


If the candidate is B, is the candidate willing to accept an A2 or A2B donor: (Values: Yes, No).


Note: This question only displays if the candidate has an ABO blood type of B.


If the candidate is willing to accept an A2 donor or A2B donor, enter IgG antibody titer: Select the titer from the choices in the drop-down list. (Values: 1:1, 1:2, 1:4, 1:8, 1:16, 1:32, 1:64, > 1:64). This field is required if a Titer date is entered.


Titer: (Values: 1:1, 1:2, 1:4, 1:8, 1:16, 1:32, 1:64, > 1:64). This field is required if a Titer date is entered.


Date: MM/DD/YYYY format. This field is required if a Titer value is selected.


Candidate current eligibility status for A2 and A2B donor: Read-only field. System will indicate if candidate is eligible to match with A2 or A2B donors.


If the candidate blood type is O, this section displays:


Note: The image below shows the same Titer Information section for a candidate who has an ABO blood type of B.



If the candidate is O, is the candidate willing to accept an A2 donor: (Values: Yes, No).


Note: This question only displays if the candidate has an ABO blood type of O.


If the candidate is willing to accept an A2 donor, enter anti-A titer: (Values: 1:1, 1:2, 1:4, 1:8, 1:16, 1:32, 1:64, > 1:64). This field is required if a Titer date is entered.


Titer: (Values: 1:1, 1:2, 1:4, 1:8, 1:16, 1:32, 1:64, > 1:64). This field is required if a Titer date is entered.


Date: MM/DD/YYYY format. This field is required if a Titer value is selected.


Candidate current eligibility status for A2 donor: Read-only field. System will indicate if candidate is eligible to match with A2 or A2B donors.



Verify Candidate ABO

The ABO must be verified by a second user before the candidate can be eligible for KPD match runs. Select the candidate's KPD ID link to access the candidate record. To verify the ABO, click the candidate's KPD ID below.



Verify Candidate ABO Candidate Information


Last name: Candidate last name. This field is read-only.


First name: Candidate first name. This field is read-only.


Middle initial: Candidate middle initial. This field is read-only.


ABO: (Values: O, A, A1, A2, B, AB, A1B, A2B). This field is required.


Age: Candidate age. This field is read-only.


Gender: Candidate gender. (Values: Male, Female). This field is read-only.


First user ABO entry: The name of the first person to enter the ABO also displays. This field is read-only.



Donor Pre-screen Candidate information


All information in this section is read-only.


KPD Candidate ID: Unique numeric ID generated by system. This field is read-only.


Candidate name: Candidate name entered on the candidate record. This field is read-only.


Candidate HLA: Candidate HLA values entered on candidate record. This field is read-only.


Candidate CPRA: Calculated by system. This field is read-only.


Candidate unacceptable antigens: Candidate unacceptable antigens entered on candidate record. This field is read-only.


All other antibody specificities: Candidate other antibody specificities entered on candidate record. This field is read-only.


Candidate ABO: Candidate ABO entered on candidate record. Values (O, A, A1, A2, B, AB, A1B, A2B) entered on donor record. This field is read-only.



Screen: Donor Pre-screen

Section: Potential donors available for pre-screening


Donors that are available for pre-screening for a candidate display in this section.


KPD Donor ID: Unique numeric ID generated by system. This field is read-only.


Donor HLA: KPD donor HLA values entered on donor record. This field is read-only.


BMI/Height/Weight: KPD Donor Height, Weight and BMI entered on donor record. This field is read-only.


Creatinine Clearance (ml/min): Donor creatinine clearance entered on donor record. This field is read-only.


GFR (isotopic method) (ml/min/1.73 m2): KPD donor GFR entered on donor record. This field is read-only.


Age: KPD donor age entered on donor record. This field is read-only


M/F: KPD donor gender entered on donor record. Values: M, F. This field is read-only.


ABO: KPD donor ABO entered on donor record. Values (O, A, A1, A2, B, AB, A1B, A2B) entered on donor record. This field is read-only.


Kidney choice: KPD donor kidney choice entered on donor record. Values: Left kidney, Right kidney, Either kidney. This field is read-only.


Left kidney arteries: KPD donor left kidney arteries entered on donor record. This field is read-only.


Left kidney veins: KPD donor left kidney arteries entered on donor record. This field is read-only.


Left kidney ureter: KPD donor left kidney ureter entered on donor record. This field is read-only.


Right kidney arteries: KPD donor right kidney arteries entered on donor record. This field is read-only.


Right kidney veins: KPD donor right kidney arteries entered on donor record. This field is read-only.


Right kidney ureter: KPD donor right kidney ureter entered on donor record. This field is read-only.


Pre-accept/Pre-refuse: Values: Pre-accept or Pre-refuse. This field is not required.


Pre-screen last updated: Date the pre-accept/Pre-refuse field was last updated. Date: MM/DD/YYYY format. This field is read-only.


Donor last updated: Date the KPD donor record was last updated. Date MM/DD/YYYY format. This field is read-only.



Donor pre-screen Donors pre-refused


Donors that have been refused will display in the Donors pre-refusal section. Pre-refuse/pre-accept is not required.



KPD donor ID: Unique numeric ID generated by system. This field is read-only.


Donor HLA: KPD donor HLA values entered on donor record. This field is read-only.


BMI/Height/Weight: KPD Donor Height, Weight and BMI entered on donor record. This field is read-only.


Creatinine clearance (ml/min): Numeric value entered on KPD donor record. This field is read-only.


GFR (isotopic method) (ml/min/1.73 m2): Numeric value entered on KPD donor record. This field is read-only.


Age: KPD donor age entered on donor record. This field is read-only.


M/F: KPD donor gender. (Values: Male, Female). This field is read-only.


ABO: KPD donor ABO. (Values: O, A, A1, A2, B, AB, A1B, A2B). This field is read-only.


Kidney choice: KPD donor kidney choice entered on donor record. (Values: Left kidney, Right kidney, Either kidney). This field is read-only.


Left kidney arteries: KPD donor left kidney arteries entered on donor record. This field is read-only.


Left kidney veins: KPD donor left kidney arteries entered on donor record. This field is read-only.


Left kidney ureter: KPD donor left kidney ureter entered on donor record. This field is read-only.


Right kidney arteries: KPD donor right kidney arteries entered on donor record. This field is read-only.


Right kidney veins: KPD donor right kidney arteries entered on donor record. This field is read-only.


Right kidney ureter: KPD donor right kidney ureter entered on donor record. This field is read-only.


Pre-accept/Pre-refuse: (Values: Pre-accept, Pre-refuse). This field is not required.


Pre-screen last updated: Date the pre-accept/Pre-refuse field was last updated. Date: MM/DD/YYYY format. This field is read-only.


Donor last updated: Date the KPD donor record was last updated. Date: MM/DD/YYYY format. This field is read-only.



Donor Pre-screen Donors Pre-accepted


Donors that have been pre-accepted for a candidate will display in the Donors pre-accepted section. Pre-refuse/pre-accept is not required.


KPD Donor ID: Unique numeric ID generated by system. This field is read-only.


Donor HLA: KPD donor HLA values entered on donor record. This field is read-only.


BMI/Height/Weight: KPD Donor Height, Weight and BMI entered on donor record. This field is read-only.


Creatinine Clearance (ml/min): Numeric value entered on KPD donor record. This field is read-only.


GFR (isotopic method) (ml/min/1.73 m2): Numeric value entered on KPD donor record. This field is read-only.


Age: KPD donor age entered on donor record. This field is read-only


M/F: KPD donor gender. (Values: Male, Female). This field is read-only.


ABO: KPD donor ABO. (Values: O, A, A1, A2, B, AB, A1B, A2B). This field is read-only.


Kidney choice: KPD donor kidney choice entered on donor record. (Values: Left kidney, Right kidney, Either kidney). This field is read-only.


Left kidney arteries: KPD donor left kidney arteries entered on donor record. This field is read-only.


Left kidney veins: KPD donor left kidney arteries entered on donor record. This field is read-only.


Left kidney ureter: KPD donor left kidney ureter entered on donor record. This field is read-only.


Right kidney arteries: KPD donor right kidney arteries entered on donor record. This field is read-only.


Right kidney veins: KPD donor right kidney arteries entered on donor record. This field is read-only.


Right kidney ureter: KPD donor right kidney ureter entered on donor record. This field is read-only.


Pre-accept/Pre-refuse: Values: Pre-accept or Pre-refuse. This field is not required.


Pre-screen last updated: Date the pre-accept/Pre-refuse field was last updated. Date: MM/DD/YYYY format. This field is read-only.


Donor last updated: Date the KPD donor record was last updated. Date: MM/DD/YYYY format. This field is read-only.





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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleKidney Paired Donation Candidate Registration_Instructions
File Modified0000-00-00
File Created2022-02-18

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