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St. Michael's Hospital – Stat Cross Match Decision Algorithm for Deceased Donor Renal Transplant 2014-05-05

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ST. MICHAEL'S HOSPITAL STAT CROSS MATCH DECISION ALGORITHM FOR DECEASED DONOR RENAL TRANSPLANT 2014-05-05

YESLiving Donor Graft

Survival.pdf

ANY PRA: HAS THE RECIPIENT HAD A SENSITIZING EVENT SINCE LAST SERUM DATE?

STAT XM (NO EXCEPTIONS)

BRING IN BACKUP

NO BACKUP

Is the cPRA >80%

YES

NO

DOCTOR to obtain from TGLN coordinator Date of last serum sample Number of serum samples in TGLN Are there DP DSA? Was there a possible allele specific DSA assessed and ruled out by lab? ON CALL NURSE to ASK RECIPIENT Any recent sensitizing event? (transfusion, pregnancy, miscarriage)

**IF A TIME SENSITIVE ISSUE FOR

STAT XM Clinician should call HLA lab director to discuss safety of

omitting stat XM in a sensitized patient

ANY PRA: DOES THE RECIPIEINT HAVE DP DSA? AND/OR WAS AN ALLELE SPECIFIC DSA POSSIBLE BUT RULED OUT BY LAB?

Backup on case-by-case basis STAT XM**

How many sera are registered at TGLN?

YES

NO

Is the cPRA 1-80%

YES

NO

NO

Routine Priority XM

Reconfirm: cPRA is 0% with at least 2 sera tested, or 0% with single serum