User Manual - DonateLife
Contents
1. Altruistic donor omit sections 1 amp 3 O Yes O No SECTION 3 Donor Recipient Information O Spouse O Parent O Sibling Relationship of incompatible donor to potential recipient O 1st degree relative O Friend O Other specify Other ae a blood group incompatible with the O No O Yes e ee aver Notte SECTION 4 This form completed by Full name please print Position Signature Date Hard copies of Blood group and Virology results attached donor amp recipient O Yes Please indicate for which quarterly AKX Run this pair or altruistic donor willbe ready O1 02 O37 O4 AKX User Manual Version 2 October 2014 Form 5 1 This page is intentionally blank Organ and Tissue Authority EXCHANGE PROGRAMME Surgical Checklist Please complete this form and fax to 08 9431 3902 or scan and email to claudia woodroffe health wa gov au STEP 1 Completed by the AKX Programme Coordinator and sent to the Donor Transplant Surgeon a Date CD fd ate report of donor Potential Match is a i a ABOi Transplant Llyes CTA sent to recipient identified centre Kno Donor Transplant Recipient Transplant Centre Centre Liaison surgeon Liaison surgeon Phone number Phone number Email Email Donor name Recipient initials Donor NOMS ID Recipient NOMS ID Donor DOB Recipient DOB Blood group Blood group STEP 2 Completed by Do2. SECTION 1 Donor Surgery Donor Theatre Location Designated Theatre Designated Theatre Number Phone Extension Donor Surgeon Mobile Phone Number Anticipated Kidney Donor Anaesthetic Start time 5 Pick up time Recipient Surgeon assisting with packaging if applicable Hospital Pick up point Renal Transplant Coordinator or delegate Mobile Phone Number Mobile Phone Number Emergency contact 7 BENCY Theatre reception Number e The designated theatre phone extension number is essential and will be used for backup communication e Donor anaesthetic start time will be synchronised with exchange centre and may change on the day e Onsite recipient surgeon to assist with packing of kidney is required if donor surgeon is not familiar with AKX packaging procedure e Anticipated kidney pick up time will be based on donor surgeon advice e Hospital pick up point may be theatre reception or an alternate pre designated site agreed upon with courier e Renal Transplant Coordinator or delegate necessary for in theatre communication e Mobile phone numbers will be used for SMS alerts please check mobile reception in theatres e Emergency contact may be another on duty transplant coordinator or theatre reception staff SECTION 2 Recipient Surgery Recipient Theatre Location Mobile Phone Recipient Surgeon Number Hospital Delivery Point Contact Phone
3. Have read and understood the Agreement to Participate and conditions of participation and all questions have been answered Have been fully informed about all other transplant options for living kidney donation from an incompatible donor Understand that the AKX is not an enforceable contract but a reciprocal arrangement with no monetary reward or benefit other than the exchange of kidneys Are aware that they can withdraw at any time up until the surgery Are aware that there are no legal remedies for the exchange not proceeding Anonymity of donors and recipients will be maintained Name print Position Signed Date AKX User Manual Version 2 October 2014 Form 4 PAIRED KIDNEY Se a ieee EXCHANGE PROGRAMME Australian Government Donor name Recipient name SECTION 2 Completed by the AKX Programme Coordinator and forwarded to the Minister for Health or delegate Exemption requested under tick Section 44 4 of the Transplantation amp Anatomy Act 1978 Australian Capital Territory Section 32 4 of the Human Tissue Act 1983 New South Wales Section 22F of the Transplantation and Anatomy Act Northern Territory Section 35 6 of the Transplantation and Anatomy Act 1983 South Australia Section 27 4 of the Human Tissue Act 1985 Tasmania Section 29 4 a of the Human Tissue and Transplant Act 1982 Western Austra
4. Hospital Contact Number e If donor and recipient surgeries are in different locations please provide alternate delivery point amp contact details as necessary e Hospital contact for pick up and delivery may be renal transplant coordinator or theatre reception staff AKX User Manual Version 2 October 2014 Form 7 1 This page is intentionally blank Orm Testori EX CHANGE PROGRAMME AKX Transport Itinerary amp Contingency Plan bate ot change Pick Up Deli T lant N Transplant Centre Theatre Location ae p ue A N UESe Point Primary Contact ooo ooo Pf AKX User Manual Version 2 October 2014 Form 8 1 Organ and Tissue Authority EXCHANGE PROGRAMME as From To PiupTines Departure arrivat Fight No approx Delivery Time a A NF Primarywineray SS Contingency Plan Next available flight E E als E ee rl ea ae eam Sm a Primarvrineray TT PT Fas From To Pup Tines Departure Ariva Fight No Approx Delivery Time C S S a S S S mae O S S s S e id Cen Contingency Plan Next available flight D Donor R Recipient DAS Donor Anaesthetic Start WST Western Standard Time EDST Eastern Daylight Saving Time CDST Central Daylight Saving Time AKX User Manual Version 2 October 2014 Form 8 2 Organ and Tissue suttoriy EXCHANGE PROGRAMME Contingency Transport Plan
5. The AKX Programme Contingency Transport Plan is implemented in the event that the planned primary transport itinerary fails This failure could be due to such events as a missed delayed or cancelled flight traffic congestion or poor weather Of note a kidney may also be picked up earlier than expected and may be able to be uplifted on an earlier flight The Contingency Plan provides further pre arranged options for transport of the organ In the event of an anticipated itinerary change the National Coordination Centre NCC emergency contact must be immediately notified and will confirm with StarTrack and the transplant centres the arrangements in place to enact an alternate itinerary Such arrangements may include transport via a later or earlier commercial flight depending on the circumstances for the change Emergency Contact Details Those listed may be contacted if there are any issues with the implementation of the primary transport plan in the event that the contingency plan must be enacted for surgical progress reports or when any further information is required Transplant nurses at each site will receive real time SMS alerts at specific intervals by StarTrack and the NCC with tracking information for their outgoing and incoming kidneys fa Next Flight 24 7Team orse O 2 S d Melissa Smedley oersaes aoo o S Tammi Markowicz fooson CCS a Diane Tessensohn oosa ao Claudia Woodroffe oosrsss C A T D Ss i Dial In 1300 30
6. Form and determine if a local or systems issue exists Local issue Issues identified where corrective action is required at local level only will be directed to the donor or recipient hospital Systems Issue Issues identified where action is required by all relevant transplanting teams and or national courier company will be addressed by the AKX in consultation with the Renal Transplant Advisory Committee and or OTA AKX User Manual Version 2 October 2014 Form 9 2 ae astian Goyet nieni PAIRED KIDN EY Orgnand Twe Authority EXCHANGE PROGRAMME Informed consent discussion checklist This check list for clinicians is to ensure that consistent consent information is provided to patients during consent discussions The information in this checklist is based on the consent protocols developed by the AKX Advisory Group and the key points covered in the agreement to participate Voluntary Participation Donors and recipients can withdraw for any or no reason at any time up to the commencement of surgery O Yes O No Donation and Transplantation Success Process of orphaned kidney discussed LlYes LI No Process of orphaned recipient discussed LlYes LI No Discuss process if a transplanted kidney fails the recipient will be assessed and treated as appropriate for eg going back on the transplant waiting list if eligible or considering whether they have other potential donors O Yes O No If a transplanted kidney
7. S Surname family name essecseceesteceeseesessessecseseseeeessteateeeeeeees Given MAMME cessssssssssssstsssseseseseeeeeceeeeeeeeeensneeesnnnannnnnnnnnnssnsssecs GIVEN NAM Enia nain a i Date of birth AEE TREN AKX User Manual Version 2 October 2014 Form 3 1 This page is intentionally blank PAIRED KIDNEY EXCHANGE PROGRAMME Australian Government Organ and Tissue Authority Ministerial approval form Donor name Recipient name ACT NSW SA NT WA and TAS Please complete section 1 of this form attach the signed Agreement s to Participate not required for SA NT and fax or scan and email to the National Coordination Centre fax 08 9431 3902 email claudia woodroffe health wa gov au If you have any queries regarding this form please phone the AKX Programme Coordinator on 08 9431 3690 or email as above SECTION 1 Donor Recipient Details and Declaration Completed by the appropriate Senior Medical Specialist and forwarded to the National Coordination Centre The form will be returned once the Minister for Health has signed it Donor Details Recipient Details Surname Surname First name First name Middle name Middle name Date of birth Date of birth Location of surgery Location of surgery Physician Physician Donor relationship to recipient Declaration confirm that the donor and or the recipient circle tick
8. finding a match Only the donor with the best match will actually donate their kidney Individuals with common blood types and low levels of sensitisation to other blood and tissue antigens will also have a greater chance of matching Alternatively your doctor may discuss other options What should do next For more information ask your kidney specialist Counselling support will be available to donor recipient pairs through the transplant centre both before and after the paired kidney exchange Where can get further information Australian Paired Kidney Exchange AKX Programme Attention Programme Coordinator Department of Nephrology Fremantle Hospital PO Box 480 FREMANTLE WA 6160 Phone 08 9431 3690 Fax 08 9431 3902 Organ and Tissue Authority www donatelife gov au AKX User Manual Version 2 October 2014 Form 1 3 This page is intentionally blank Organ and Tissue Authority EXCHANGE PROGRAMME Recipient agreement to participate have reviewed the Australian Paired Kidney Exchange Programme Agreement to Participate the Agreement and conditions of participating with this patient and his her potential donor Transplant Physician Surgeon Date Transplant Coordinator witness Date tick have read and understand the Agreement to Participate and conditions of participation and all my questions have been answered have been fully informed about all of my other transplant options for liv
9. with 80 for transplants for cadaveric deceased donors A paired kidney exchange can happen when a live donor Donor 1 who is willing to donate to a spouse friend or relative Recipient 1 is unable to donate because they have an incompatible blood type or tissue type AKX will help fund compatible donors amongst other registered pairs such as Donor 2 and Recipient 2 as shown below who might be a suitable match and thus enable two compatible living donor transplants to occur Donor 1 Donor 2 Yr J NG Y E J E B amp D D 2 5 5 oO is X X Recipient 1 Recipient 2 How does AKX work If you have a willing but incompatible living donor participating in the Australian Paired Kidney Exchange AKX Programme will increase the chance that you will be able to receive a living donor kidney transplant Should you agree to participate in the programme your information will be registered in a secure computer database containing all the register donor recipients pairs across Australia The computer program searches the entire available database of registered recipient donor pairs to look for combinations that might enable a suitable kidney exchange to occur If the computer finds a potential match doctors will arrange for the final tissue typing test for you and your willing living donor If no match is found in the first match run the computer matching you and your donor will be kept on the register and will be incl
10. 0 805 iiia Conference Code 8406163 po Transplant Nurse pf Donor Surgeon Donor Operating Theatre Theatre a a e a a E if SSCSC S o o F ce Joo O S a e S SSCS E D Eoo po Transplant Nurse i Donor Surgeon Recipient Surgeon Donor Operating Theatre Theatre AKX User Manual Version 2 October 2014 Form 8 3 Donor Operating Theatre Theatre This page is intentionally blank Organ and Tissue Authority EXCHANGE PROGRAMME Living Kidney Donation Report Please complete this form and fax to the AKX Programme Coordinator on 08 9431 3902 or email claudia woodroffe health wa gov au SECTION 1 Completed by the Renal Transplant Coordinator or Surgeon present at retrieval and forwarded with donor kidney Donor Initials Donor NOMS ID number Donor Hospital Donor Blood Group Date of Retrieval Donor Surgeon Donor Date of Birth Renal Transplant Time of Artery cross clamp Coordinator Left or Right Kidney Time Kidney on ice Perfusion fluid ORoss OUW O specify Heparinisation used O10000u 20000u ONone No of arteries SECTION 2 Completed by the donor surgery team Abnormal findings or damage short vein ureter etc O Yes O No Comments Kidney checked for complete perfusion external examination of parenchyma O Yes Recipient surgeon telephoned post nephrectomy and advised re any issues O Yes Donor Surgeon signature Transp
11. ES souninemn PAIRED KIDNEY 4 orena tisusut EXCHANGE PROGRAMME Australian Paired Kidney Exchange AKX Programme User Manual Version 2 released October 2014 Index Forms AKX FAQs AKX Agreement to participate donor and recipient consent forms AKX Donor Declaration form AKX Ministerial Approval form AKX Tissue Typing Registration form AKX Surgical Checklist form AKX Day of Exchange Details form AKX Transport Itinerary Contingency Plan AKX Living Kidney Donation Report 10 AKX Informed Consent Discussion Checklist WON AMWRWNE This page is intentionally blank aaan PAIRED KIDNEY Organand Tisue Autry EXCHANGE PROGRAMME Frequently Asked Questions Information for patients and willing living donors What is the Australian Paired Kidney Exchange AKX Programme The Australian Paired Kidney Exchange AKX Programme is a nationwide live kidney exchange programme The goal of AKX is to increase live kidney donor transplant by identifying matches for incompatible donor recipient pairs AKX is part of the Organ and Tissue Authority s efforts to increase available organs from live donors Approximately 30 of potential donors fail to fulfil their wish to donate a kidney to a relative of friend due to incompatible blood group or tissue matches Long term results from living donor kidney transports are excellent Five years after the transplant 88 of transplants from live donors are still functioning compared
12. fails the recipient will be assessed and treated as appropriate for example going back on the transplant waiting list if eligible or considering whether they have other potential donors O Yes O No Privacy and Confidentiality Strict privacy and confidentiality must be maintained for each donor recipient pair including Staff involved in the programme cannot facilitate meeting of donors and recipients after the transplants LlYes O No Donors and recipients should avoid seeking publicity through the media or other means O Yes O No Data Discuss human biological materials and data that will be collected and the health and other records to be accessed their intended uses storage and duration of storage transfer and disposal procedures In this regard each transplant centre will follow its own specific ethical guidelines O Yes O No Data may be used to provide information to the Australia and New Zealand Dialysis and Transplant Registry O Yes O No National Paired Kidney Exchange Programme Advisory Group An advisory group of the National Cognate Committee on Organ amp Tissue Donation amp Transplantation AKX Guidelines page 13 AKX User Manual Version 2 October 2014 Form 10 1
13. have you staff use only 1 Ever had a test which showed you had hepatitis B hepatitis C or HIV Yes O No O Ever thought you could be infected with HIV or have AIDS Yes O No O Ever used drugs by injection or been injected even once with drugs not prescribed by a doctor or dentist Yes O No O 4 Ever had treatment with clotting factors such as Factor VIII or Factor IX Yes O No O 5 Inthe last 12 months had an illness with unexplained night sweats swollen glands and a rash with or without a fever Yes O No O Within the last 12 months have you 6 Had a tattoo including cosmetic tattooing body and or ear piercing electrolysis or acupuncture Yes O No O Been injured with a used needle needle stick injury Yes O No O Had a blood body fluid splash to eyes mouth nose or to broken skin Yes O No O Had a blood transfusion Yes O No O 10 Been imprisoned in a prison or lock up Yes O No O 11 Had yellow jaundice or hepatitis or been in contact with someone who has Yes O No O 12 Engaged in ANY of the following sexual behaviors with or without a condom had male to male sex Yes O No O had sexual activity with a male or female sex worker been a male or female sex worker had sexual activity with someone you might think would answer yes to any of the above questions 1 11 Please ONLY sign in the presence of the interviewer Witness Surname family NAME ssssssssssssseseseesenssssssssssssenitsnssssen
14. ing kidney donation from an incompatible donor consent to my personal information including my health information being used and disclosed for the purposes explained in the Agreement consent to AKX reporting personal information to ANZDATA and ANZDATA to report to the AKX Programme for the purposes explained in the Agreement hereby agree not to participate in interviews with the media prior to the exchange taking place hereby agree and consent to participate in the Australian Paired Kidney Exchange Programme and understand that can withdraw my consent for participation at any time without penalty or disadvantage Name print Address Phone Number Email Signed Date Scan and upload onto MMEx or copy amp post fax or email to Australian Paired Kidney Exchange Programme Attention Programme Coordinator Department of Nephrology Fremantle Hospital FREMANTLE WA 6160 Ph 08 9431 3690 Fax 08 9431 3902 E claudia woodroffe health wa gov au AKX User Manual Version 2 October 2014 Form 2 1 PAIRED KIDNEY Se a ieee EXCHANGE PROGRAMME Australian Government Donor agreement to participate have reviewed the Australian Paired Kidney Exchange Programme Agreement to Participate the Agreement and procedures with this donor and his her potential recipient Transplant Physician Surgeon Date Transplant Coordinator w
15. itness Date Type of donor tick applicable directed altruistic tick have read and understand the Agreement to Participate and conditions of participation and all my questions have been answered have read and understand the Agreement to Participate and conditions of participation and all my questions have been answered as a living kidney donor have been fully informed about all other transplant options for my intended incompatible recipient Not applicable if altruistic consent to my personal information including my health information being used and disclosed for the purposes explained in the Agreement consent to AKX reporting personal information to ANZDATA and ANZDATA to report to the AKX Programme for the purposes explained in the Agreement hereby agree not to participate in interviews with the media prior to the exchange taking place hereby agree and consent to participate in the Australian Paired Kidney Exchange Programme and understand that can withdraw my consent for participation at any time without penalty or disadvantage Name print Address Phone Number Email Signed Date Scan and upload onto MMEx or copy amp post fax or email to Australian Paired Kidney Exchange Programme Attention Programme Coordinator Department of Nephrology Fremantle Hospital FREMANTLE WA 6160 Ph 08 9431 3690 Fax 08 9431 3902 E claudia w
16. lant Surgeon signature only if donor surgeon is not a credentialed transplant surgeon SECTION 3 Completed by the Transplanting Surgical team and forwarded to AKX Secretariat within 2 working days of procedure to above fax number Date of Transplant Recipient Initials Recipient NOMS ID number Recipient Hospital Recipient Blood Group Recipient Date of Birth Transplanting Surgeon Kidney Side Time Kidney off ice Time of Reperfusion No Problems Identified O Problems Identified Please complete if problems were identified 3 1 Inadequate Paperwork Please circle Labelling donor documentation recipient documentation 3 2 Packaging Transportation v 3 3 Technical Anatomical Problems v 3 2 1 Insufficient preservation fluid in bags 3 3 1 Peri nephric fat not removed adequately 3 2 3 Damaged container 3 3 2 Incomplete perfusion of kidney 3 2 3 Other incl delays please specify 3 3 3 Damaged artery s 3 3 4 Damaged vein 3 3 5 Damaged ureter insufficient length 3 3 6 Non identified abnormal anatomy 3 3 7 Non identified pathology 3 3 8 Other please specify AKX User Manual Version 2 October 2014 Form 9 1 Organ and Tissue Authority EXCHANGE PROGRAMME Please indicate specific problems and provide diagram if appropriate Recommendations or Comments SECTION 4 Completed by AKX Secretariat and forwa
17. lia A copy of the signed Agreement to Participate Donor is attached not required for SA NT A copy of the signed Agreement to Participate Recipient is attached not required for SA NT Date approval requested Requested by SECTION 3 Approval to be signed by the Minister for Health or delegate and returned to the National Coordination Centre Note that approval is required within five days of receiving this request Approved Y Name print Position Signed Date AKX User Manual Version 2 October 2014 Form 4 2 t Organ and Tissue Authority EXCHANGE PROGRAMME Paired Kidney Donation Tissue Typing Registration Form Referral Centre State Transplant Centre Nephrologist Phone Email Transplant nurse Phone Email SECTION 1 Recipient Details Recipient surname Sex O Male O Female Recipient first name Date of Birth If recipient is cared for at a different centre please indicate recipient s centre NOMS recipient National ID if known Dialysis start date Pre emptive O Yes O No SECTION 2 Donor Details Donor surname Sex O Male O Female Donor first name Date of Birth If donor is cared for at a different centre please indicate donor s centre NOMS donor National ID if known
18. nor Transplant Surgeon and forwarded to NCC within 2 working days of receipt Left or Right kidney for removal O left O right Comments Mandatory if right donor nephrectomy preferred Perfusion solution O uw LlOther please specify Heparin in perfusion fluid O 10000U L ClNone Donor Surgeon Signature Date signed The NCC will submit Donor surgical checklist to Recipient Transplant Surgeon to acknowledge the offer STEP 3 Completed by Recipient Transplant Surgeon and returned to NCC within 2 working days of receipt Proposed organ acceptable Dyes Ono If NOT acceptable please specify why sign and return this form immediately to the NCC Comments If exchange is acceptable please sign and return this form to the NCC Recipient surgeon signature oatesned signed STEP 4 Completed by the NCC and forwarded to Donor amp Recipient Centres Exchange confirmed by donor Proposed Date of and recipient centres Cyes C no Exchange AKX User Manual Version 2 October 2014 Form 6 This page is intentionally blank Organ and Tissue Authority EXCHANGE PROGRAMME Day of Exchange Details Please complete this form scan and fax to AKX Programme Coordinator 08 9431 3902 or email to claudia woodroffe health wa gov au If there are any queries regarding this form please phone the AKX Coordinator on 08 9431 3690 Date of Surgery Transplant Centre
19. onors are sure that each has proceeded with the surgery Each recipient receives their kidney on the same day as their wiling living donor partners donates Can contact the other couple No Strict privacy and confidentiality will be maintained for each donor recipient pair This is one of the reasons we endeavour to use different hospital sites for the two pairs of donors and recipients The National Health and Medical Research Council NHMRC Organ and Tissue Donation by Living Donors Guidelines for Ethical Practice for Health states that anonymity between donors and recipients should be maintained to avoid possible future repercussions for either party Can change my mind after have joined the programme Donors and recipients can change their minds at any time leading up to and including the day of surgery The donor operations are coordinated to take place at exactly the same time so that neither party is disadvantaged if one member of a donor pair chooses to withdraw from the exchange donation at the last minute AKX User Manual Version 2 October 2014 Form 1 2 Organ tise authors EX CHANGE PROGRAMME What is the chance of finding a match The chance of finding a suitable match depends on a number of factors The more donor recipient pairs registered on the programme database the greater the chance of finding a match If a patient has more than one donor who is willing to enter the programme they have a greater chance of
20. oodroffe health wa gov au AKX User Manual Version 2 October 2014 Form 2 2 Organand Tisue Autry EXCHANGE PROGRAMME Donor Declaration Form As part of the assessment of potential living kidney donors the completion of the following questionnaire is necessary to identify potential factors which could lead to transmission of infection or other medical conditions There are some people who MUST NOT donate organs as they may transmit infections to those who receive them To determine if your donation will be safe to the person receiving your organ we would like you to answer some questions These questions are vital in our efforts to eliminate diseases from the organ supply If you do not wish to complete the questionnaire you may withdraw your consent and consideration for donation All information remains strictly confidential in accordance with the Federal Privacy Act In addition to the questionnaire all organ donors are tested for the presence of hepatitis B and C and HIV If your blood test proves positive for any of these conditions or for any reason the test shows a significantly abnormal result you will be informed These blood tests are performed in the early stages during your medical assessment to determine your suitability for kidney donation and repeated again about 1 week prior to scheduled surgery Please respond by placing a cross or a tick in the relevant box Do not circle Comments To the best of your knowledge
21. r discussion if the donor recipient pairs agree to the exchange they will sign the appropriate consent forms for surgery There is no guarantee that the transplant will occur even if you are identified for a possible donor recipient exchange There are many health and emotional issues to be considered in the paired kidney exchange programme and the process is complex You will receive advice and support to help to understand these issues What happens if no match is found Patients who don t find a matching donor through the exchange programme still have the chance of receiving a kidney transplant If patients are eligible for the deceased donor waiting list they will remain on the deceased donor transplant waiting list The chance of finding a successful match for exchange should increase as more donor recipient pairs join the programme If no match is found in your first match run you can remain on the register and re enter subsequent match runs However if no suitable pair matches are found are a period of time you may wish to consider other options after discussion with your kidney specialist Where would the transplant take place If all parties agree to an exchange and are medically compatible the two transplant surgeries take place at two different transplant centres Each donor recipient pair remains at their own transplant centre Both operations occur at the same even if the other transplant is in another state In this way both d
22. rded to Transplant centres Date of Exchange Transplant Centres Date form received from Date completed form sent to Recipient centre centres Warm Ischaemia Cold Ischaemia Total Ischaemic Time Local issue O OR System Issue O Date tabled at AKX Advisory Committee Action AKX Kidney Retrieval Report Form process 1 Completion of the form gt Section 1 Completed by the Renal Transplant Coordinator or Surgeon at donor hospital gt Section 2 Completed by the donor nephrectomy Surgeon noting any problems identified or specific comments The donor hospital Renal Transplant Coordinator or delegate will send this form with the donor kidney to the recipient transplanting hospital team A copy of the form should be filed in the confidential AKX donor records gt Section 3 Completed by the recipient hospital Transplanting Surgeon or delegate noting problems identified and any recommendations 2 Processing the form gt Recipient Hospital Renal Transplant Coordinator or Transplant Surgeon to i fax the completed form or ii scan and email the completed form within two working days to the National Coordination Centre Fax 08 9431 3902 Email claudia woodroffe health wa gov au gt AKX secretariat to forward a copy of completed report to Donor amp Recipient centres for filing as per AKX Protocol 3 Review gt Section 4 The National AKX Advisory committee will review each Report
23. uded in further computer match runs If no match is found after several match runs your kidney specialist will discuss other options that are available to you AKX User Manual Version 2 October 2014 Form 1 1 Australian Government PAIRED KIDNEY lt Organ and Tissue Authority EXCHANGE PROGRAMME How can join AKX To register with AKX you should contact your kidney specialist You and your willing donor will be asked to have the programme explained to you by a medical professional sign an Agreement to Participate form stating that you understand this programme and agree to participate provide a detailed medical history undergo a number of medical tests Who can participate If you are a patient who is eligible for a kidney transplant and are receiving care at a transplant centre renal unit in Australia you may be able to participate in the programme You must have a living donor who is willing but unable to donate to you because of an incompatible blood type of tissue type Your donor must be willing to take part in the Programme and donate a kidney to someone else What happens if a match is found If a match is found you will be informed by your kidney specialist Further testing will be required to confirm that the recipient and potential donor are compatible Once the testing in completed each donor and recipient pair will meet with their own transplant team to discuss the results and whether to proceed Afte
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