A

Acute rejection - The body's attempt to destroy the transplanted organ. Acute rejection usually occurs in the first year after transplant.

Administrative fee - An amount of money charged by an organization that is handling your fundraising money.

Adverse reaction - An unintended side effect of a drug.

Advocacy organization - A group that helps someone get what they need or want, promotes a certain point of view, or pleads the case of another.

Allocation - The process of determining how organs are distributed. Allocation is based upon a system of policies and guidelines that are followed to ensure that organs and tissues are distributed fairly to those waiting for them.

Allograft - An organ or tissue that is transplanted from one creature to another of the same species, such as human to human. An example would be a transplanted kidney from a deceased or living human donor into a living human recipient.

Antibody - A protein substance made by the body's immune system to attack a foreign substance such as, a transplanted organ, blood transfusion, virus or pregnancy. Because antibodies attack transplanted organs, transplant patients must take powerful drugs. (See anti-rejection drugs.)

Antigen - A foreign substance, such as a transplanted organ, that triggers the body to try to destroy (reject) it.

Anti-rejection drugs (immunosuppressive drugs) - Drugs that reduce the body's ability to reject the transplanted organ.

Arbor Research Collaborative for Health - A non-profit organization established for the purpose of conducting clinical and economic studies. It administers the Scientific Registry of Transplant Recipients (SRTR) under contract to the Health Resources and Services Administration of the U.S. Department of Health and Human Services. Located in Ann Arbor, Michi^gan. Arbor Research is made up of researchers, biostatisticians, programmer analysts and research assistants who have experience in studying health-related issues.

Arteriogram - An x-ray of an artery after a dye has been injected.

Ascites - A buildup of fluid in the abdomen usually associated with liver disease.

B  

Beneficiary - The person who receives the benefits of an insurance policy.

Benefits - Services that are paid for by an insurance policy.

Biopsy - The removal (usually with a needle) of a tiny piece of tissue from the body for examination under a microscope. This test is performed to diagnose rejection of a transplanted organ.

Blood vessels - The veins, arteries, and capillaries through which blood flows. Blood vessels can be donated and transplanted.

Brain death - The irreversible cessation of all functions of the entire brain, including the brain stem. Brain death is not the same as a coma or persistent vegetative state. Brain death occurs when there is permanent, irreversible brain injury due to a hemorrhage, stroke, trauma or prolonged lack of oxygen to the brain.

C

Candidate - A person registered on the organ transplant waiting list. When an organ is offered on behalf of the candidate, he or she is then referred to as a Potential Transplant Recipient (PTR).

Cadaver - A dead body.

Cadaveric Transplant -The transplant of an organ from a deceased donor. The preferred term is Deceased Donor Transplant.

Cardiac - Having to do with the heart.

Cardiac death - The ir^reversible cessation of all heart, blood circulation, and breathing functions. A person declared dead by cardiac criteria (the heart has stopped and can not be restarted) is in some cases able to donate some organs and tissues.

Center of Excellence - An insurance term for a medical center that will negotiate a discounted price for the transplant even if that center is not part of the insurance company's PPO network.

Charitable organization - A group that does not charge a fee for its services.

Chronic - A condition that develops slowly and lasts for a long time, even the rest of the patient's life, for example, kidney failure.

Chronic rejection - Slow failure of the transplanted organ.

Cirrhosis - A disease of the liver in which normal, healthy tissue is replaced with nonfunctioning tissue, and healthy, functioning liver cells are lost. Cirrhosis usually occurs when there is a lack of adequate nutrition, infection is present or damage has been caused by alcohol abuse.

Co-insurance - A percentage of money you must pay toward a service your insurance will cover. A typical amount is 20% you pay 20 percent of the doctor's bill and your insurance company pays the other 80 percent.

Cold ischemia time - The time an organ is without blood circulation-from the time of removal of the organ from the donor to the time the organ is transplanted into the recipient.

Committees - The Organ Procurement and Transplantation Network (OPTN) currently maintains approximately 20 standing committees, a fluctuating number of ad hoc committees (established by the President to address a specific issue as it arises), subcommittees and joint subcommittees (created and maintained by standing committees). Committees are comprised of professionals, at least one Patient/ Public representative, Minority Affairs Committee Representative, Pediatric Committee Representative, and one or more SRTR representatives. Permanent Standing Committees also include representatives form each of the 11 Regions. HRSA's OPTN Project Officer and Director of DoT, or their designees, serve as ex-officio non-voting members of all committees. Each committee is provided administrative, policy, analytic, clinical and technical support by one or more committee liaisons from the UNOS staff.
 

Co-payment (co-pay) - A flat fee that a person pays for healthcare services in addition to what the insurance company pays, for example, a $10 "co-payment" each time you visit your doctor.

Corticosteroid - A hormone produced by the body but given as a synthetic (manufactured) medicine to suppress your body's normal reaction (immune response) to infection and foreign tissue, such as a transplanted organ. Prednisone is an example of a synthetic hormone.

Coverage date - The day your insurance benefits begin.

Covered benefit - A service that an insurance company will provide payment toward.

Covered service - See covered benefit.

Criteria (medical criteria) - A set of standards or conditions that must be met.

Critical care unit - See intensive care unit.

Cross matching - A blood test performed before the transplant to see if the potential recipient will react poorly to the donor organ. If the crossmatch is "positive," then the donor and patient are incompatible. If the crossmatch is "negative," then the transplant may proceed. Crossmatching is routinely performed before kidney and pancreas transplants.

Cyclosporine - A drug used to prevent rejection of the transplanted organ by suppressing, or shutting down, the body's defense system (immune response).

D

Deceased donor - A person who has been declared dead and whose organ or organs and/or tissues are used for transplantation. The deceased donor contrasts with the living donor, someone who has agreed to donate a kidney or part of an organ while still alive.

Deductible - A fixed amount of money you must pay for covered healthcare expenses before the insurance company starts to pay. This is usually a yearly amount of $250, $500, $1000 or more.

Delayed function - A condition in which the transplanted organ does not work well right after the transplant. Many kidneys have a delay before they begin to function well. Kidneys can sometimes take as long as three weeks to "wake up." Sometimes a kidney recipient needs dialysis until the kidney starts to work.

Department of Health and Human Services (HHS) - The department of the Federal Government responsible for health-related programs and issues, including overseeing the OPTN and SRTR contracts and developing organ, tissue and blood stem cell donation programs.

Dependents - Those persons who also receive insurance benefits on your policy, for example, a spouse and children.

Depilatory - A cream or spray put on the skin to dissolve and remove excess hair.

Dialysis - The use of a machine to correct the balance of fluids and chemicals in your body and to remove wastes from your body when your kidneys are failing. (See hemodialysis.)

Diastolic blood pressure - The bottom number in your blood pressure (80 in a blood pressure of 120/80), which indicates the pressure in the arteries when the heart is at rest.

Disability (disabled) - A considerable limitation in major life activity that cannot be helped with the use of a corrective device or medication. A disabled person is someone who is unable to perform the necessary functions of a job with or without a reasonable modification.

Disability Determination Service - A State agency that reviews your eligibility for vocational rehabilitation.

Disability insurance - A type of insurance that provides you with an income if illness or injury prevents you from being able to work for an extended period of time.

Division of Transplantation (DoT) - The office of the U.S. Department of Health and Human Services whose principal responsibilities for the Health Resources and Services Administration include oversight of the contracts for the national Organ Procurement and Transplantation Network (OPTN), the U.S. Scientific Registry of Transplant Recipients (SRTR), the C.W. Bill Young Cell Transplantation Program, and the National Cord Blood Inventory. The DoT also provides professional and public education to increase organ and tissue donation, and technical assistance to organ procurement organizations (OPOs).

Donate Life America - A non-profit alliance of health and science professionals, transplant patients and voluntary health and transplant organizations. Donate Life America works to increase public awareness of the critical organ shortage and create a greater willingness and commitment to organ and tissue donation.

Donor - Someone from whom an organ or tissue is removed for transplantation.

Donor card - A document that indicates your wish to be an organ donor.  To become a donor in Texas, please visit  www.donatelifetexas.org

Donor pool - A group of people eligible to donate an organ.

Donor Registries - Available 24 hours a day, seven days a week, online registries provide authorized professionals access to a confidential database of registered organ donors, allowing easy and quick confirmation of an individual's consent to organ donation. All registries are voluntary and some are affiliated with the local motor vehicle bureau, while others are independently operated or OPO-based.

Durable power of attorney - A legal document in which you name someone to make medical decisions for you when you are unable to speak for yourself.

E

Edema - Swelling caused when the body retains too much fluid, also called "water weight."

End-stage organ disease - A disease that leads to permanent failure of an organ.

End-stage renal disease (ESRD)/chronic kidney failure - A condition in which the kidneys no longer function. Patients then require dialysis or a transplant.

End-Stage Renal Disease (ESRD) Program - The part of Medicare that helps pay for dialysis or transplantation for people with end-stage kidney disease, or renal failure.

Ethnicity - For OPTN data purposes, the use of categories such as White; Black or African American; Hispanic; Asian or Native Hawaiian; or Other, which includes American Indian, Alaska Native, Mid-East or Arabian, or Indian subcontinent.

Evidence of insurability - Proof that you are healthy enough for a particular insurance company to insure you.

Exclusion - Medical services that are not paid for by an insurance policy.

Expanded Criteria Donor (ECD) Kidney - A kidney donated for transplantation from any 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, a terminal 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.

Experimental - New treatments, procedures or drugs that are being tested. Insurance companies usually do not pay for anything considered experimental.

F

Federally mandated - Required by Federal law.

Foreign body - An entity that enters the body that is not supposed to be there, such as a germ, a piece of glass, a splinter, or a transplanted organ or tissue. Your body normally attacks or tries to reject a foreign body to prevent further injury.

Foundation - An institution that provides funds for causes, issues, groups, people, etc. A foundation often has a particular interest or interests and solicits donations from those who support these interests. Some foundations help patients and their families with medical expenses.

Fulminant - Happening very quickly and with intensity, for example, fulminant liver failure or fulminant infection.

Functional Status - A way to measure the effects that lung disease may have on a person’s ability to perform routine daily tasks. Functional status is used in the Lung Allocation Score.

Fungal disease - An infection that often occurs in patients during treatment with steroids or immunosuppressants. Examples of fungal infections include candida, aspergillus, and histoplasmosis, which tend to be systemic infections.

G

Gender - The particular sex of an individual; male or female.

Genetic - Referring to heredity, birth or origin.

Genetic matching - See tissue typing.

Gingival hypertrophy - Enlargement of the gums. It can be controlled by good oral hygiene and regular dental checkups.

Glomerular filtration rate (GFR) - A measurement of kidney function used to determine the severity of kidney disease.

Graft - A transplanted organ or tissue.

Graft survival rate - The percentage of patients who have functioning transplanted organs (grafts) at a certain point in time. The data are usually measured in 1-, 3- and 5-year time periods.

Grant - An amount of money given as a gift, usually for a specific use.

Group health plan - See Group insurance.

Group insurance - Typically offered through employers, although unions, professional associations and other organizations also offer group insurance. Most, if not all, of the premium is paid by the employer.

H

Health Maintenance Organization (HMO) - insurance plan where you or your employer pay a fixed monthly fee for services, regardless of the level of care. Typically you must usually see your primary care physician and then be referred to a specialist.

Hemodialysis - A treatment for kidney failure whereby the patient's blood is passed through a machine to remove excess fluid and wastes. The procedure usually takes about 3 or 4 hours per session and is usually done about three times per week.

Hemorrhage - A rapid loss of a large amount of blood; excessive bleeding.

Hepatic - Having to do with, or referring to, the liver.

Hepatitis - An inflammation of the liver that can lead to liver failure.

High blood pressure (hypertension) (HTN) - High blood pressure occurs when the force of the blood pushing against the walls of the blood vessels is higher than normal because the blood vessels have either become less able to stretch or have gotten smaller. High blood pressure causes the heart to pump harder to move blood through the body. High blood pressure can cause kidney failure and heart disease if not treated.

Hirsutism - An excessive increase in hair growth. It is a common side effect of some drugs and can be controlled with waxing, hair removal creams or shaving.

Histocompatibility (HLA system) - The examination of human leukocyte antigens (HLA) in a patient, often referred to as "tissue typing" or "genetic matching." Tissue typing is routinely performed for all donors and recipients in kidney and pancreas transplantation to help match the donor with the most suitable recipients to help decrease the likelihood of rejection of the transplanted organ.

Human immunodeficiency virus (HIV) - A virus that destroys cells in the immune system, resulting in the eventual inability of the body to fight off infections, toxins, poisons or diseases. HIV causes AIDS (acquired immunodeficiency syndrome), a late stage of the HIV infection that can include serious infections, blindness, some types of cancer and neurological conditions such as senility.

Human leukocyte antigens (HLA) - Molecules found on the surface of white blood cells in the body that characterizes each person as unique. These antigens are inherited from your parents. In donor-recipient matching, HLA determines whether or not someone's system will accept an organ from a specific donor.

Hypertension - See High blood pressure.

I

Immune response - The body's natural defense against foreign objects or organisms, such as bacteria, viruses, or transplanted organs or tissues.

Immune system - The organs, tissues, cells and cell products in the body that work to find and destroy foreign substances, such as bacteria, viruses and transplanted organs.

Immunosuppression - The artificial suppression of the immune response, usually through drugs, so that the body will not reject a transplanted organ or tissue. Drugs commonly used to suppress the immune system after transplant include Prednisone, azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), OKT3, mycophenolate mofetil (CellCept) and tacrolimus (Prograf, FK506).

Immunosuppressive - Relating to the weakening or reducing of the immune system's responses to foreign material. Immunosuppressive drugs reduce your immune system's ability to reject a transplanted organ.

Induction Therapy - Medications given for a short finite period in the perioperative period for the purpose of preventing acute rejection. Though the drugs may be continued after discharge for the first 30 days after transplant, it will not be used long-term for immunosuppressive maintenance.

Infection - A condition that occurs when a foreign substance enters the body, causing the immune system to fight the intruder. Transplant recipients can get infections more easily because their immune systems are suppressed. It is more difficult for them to recover from infection, such as urinary tract infection, the common cold and the flu.

Inflammation - The swelling, heat and redness the body produces when it has an injury or infection.

Informed consent - The process of reaching an agreement based on a full disclosure and full understanding of what will take place. Informed consent has components of disclosure, comprehension, competence and voluntary response. Informed consent often refers to the process by which one makes decisions regarding medical procedures, including the decision to donate one's own organs or the organs of a loved one.

Inpatient treatment - Treatment in the hospital involving at least one overnight stay.

Insurance benefits - Services paid for by an insurance company.

Intensive care unit (ICU) - A unit in the hospital that has specialized monitoring devices and equipment for the care of seriously ill patients. The staff is specially trained to take care of these patients who are often critically ill or recovering from surgery.

International Normalized Ratio (INR) - A measure of a patient's coagulation (clotting) system. INR is used in the MELD and PELD calculations.

Intravenous (IV) - Within a vein or veins; usually refers to medication or fluids that are infused into a vein through a plastic catheter (narrow tube) or "line" inserted into the vein.

Investigational - A drug or procedure that is in a research phase and has not yet been approved for patient use by the Federal Drug Administration (FDA). Insurance companies normally do not pay for investigational drugs or procedures.

K

Kidneys - A pair of organs that remove wastes from your body through the production of urine. The blood in your body passes through the kidneys about 20 times every hour. Kidneys can be donated from living or deceased donors and transplanted into patients with kidney failure.

L

Legislation - A law or group of laws proposed or enacted that have the force or authority of a government or other organization.

Leukocyte - A white blood cell.

Lifetime cap - See lifetime maximum.

Lifetime maximum - The total amount of money your insurance company will pay out for your covered expenses during your lifetime. Typical amounts range from $150,000 to $5,000,000. Once you have reached your lifetime maximum, you will no longer have insurance benefits. It is very important for you to know how your insurance dollars are being spent.

Liver - Made up of a spongy mass of wedge-shaped lobes, the liver secretes bile, which aids in digestion, helps process proteins, carbohydrates and fats, and stores substances like vitamins. The liver also removes wastes from the blood. The liver can be donated and transplanted. Living donors can give part of their liver.

Living related donor (LRD) - A family member who donates a kidney or part of a lung, liver or pancreas to another family member, such as a brother to a sister, or a parent to a child.

Living unrelated donor - A person who is not related by blood who donates a kidney or part of a lung, liver or pancreas to another person, such as a husband who donates to a wife.

M

Mail-order pharmacy - A pharmacy that provides medicines and medical supplies via the mail, often at reduced costs when compared to regular pharmacies.

Managed care - A term used to describe insurance programs that try to control health costs by limiting unnecessary treatment. Health maintenance organizations (HMOs), preferred provider organizations (PPOs) and point-of-service (POS) plans and utilization review are all forms of managed care.

Match - The degree of compatibility, or likeness, between the donor and the recipient.

Medicaid - A partnership between the Federal Government and the individual States to share the cost of providing medical coverage for some patients without health insurance. Individual States decide who is eligible and what benefits and services to cover. Programs vary greatly from State to State.

Medically necessary - A specific healthcare service or supply your insurance company supports as being required for your medical treatment and as being the most efficient and economical way to provide that service. Examples would be having a minor surgical procedure performed in the doctor's office instead of staying overnight in a hospital, or renting rather than buying a piece of medical equipment.

Medicare - The Federal Government program that provides hospital and medical insurance through Social Security taxes to people age 65 and over, those who have permanent kidney failure, and certain people with disabilities.

Medicare-approved facility - A facility that meets Medicare standards for the number of transplants they do and the quality of patient outcomes.

Medigap policy (MedSupp, Medicare supplementary) - Private insurance that helps cover some of the gaps in Medicare coverage.

Mortality - Death (mortality rate = death rate).

Multiple listing - Being on the organ transplant waiting list at more than one transplant center.

N

National Organ Transplant Act (NOTA) - Passed by Congress in 1984, NOTA initiated the development of a national system for organ sharing and a scientific registry to collect and report transplant data. It also outlawed the sale of human organs in the United States.

Noncompliance - Failure to follow the instructions of the medical team, such as not taking medicines properly or not attending clinic appointments. Noncompliance can lead to the failure of a transplanted organ.

Nonfunction - A condition in which a transplanted organ fails to "wake up" (work) after being transplanted into a recipient. In the case of a kidney transplant, the recipient will return to dialysis and/or undergo another transplant.

O

OPO service area - Each organ procurement organization (OPO) provides organ recovery services for designated transplant centers throughout the United States. An OPO service area can include a portion of a city, a portion of a State or an entire State. OPOs distribute organs according to established OPTN/UNOS allocation policy.

Organ - A part of the body, made up of various types of tissues, that performs a particular function. Transplantable organs are the heart, liver, lungs, kidneys, pancreas and intestines.

Organ donation - To give an organ, such as your kidney, to someone in need of that organ, or to have your organs removed for transplantation after your death.

Organ preservation - Donated organs require special methods of preservation to keep them viable between removal and transplantation. Without preservation, the organs

will deteriorate. The length of time organs and tissues can be kept outside the body varies depending on the organ, the preservation solution and the preservation method (pump or cold storage). Common preservation times vary from 2 to 4 hours for lungs to 48 hours for kidneys.

Organ procurement or organ recovery - The act of surgically removing an organ from a donor for transplantation.

Organ Procurement and Transplantation Network (OPTN) - In 1984, Congress passed the National Organ Transplant Act that mandated the establishment of the OPTN and Scientific Registry of Transplant Recipients. The purpose of the OPTN is to administer the Nation's organ sharing system and ensure that organs are allocated in a fair and just manner. Members of the OPTN include transplant centers, OPOs, histocompatibility laboratories, voluntary healthcare organizations and the general public. LINOS operates the OPTN under contract to the U.S. Department of Health and Human Services.

Organ procurement organization (OPO) - OPOs serve as the vital link between the donor and recipient and are responsible for the identification of donors and the removal, preservation and transportation of organs for transplantation. OPOs also collect data on deceased donors for the Scientific Registry of Transplant Recipients. OPOs also engage in public and professional education to increase the rate of organ donation in their communities. Currently, there are 58 OPOs around the country. All are OPTN members.

Out-of-pocket expenses - The portion of health costs that must be paid by the insured

person per year, including deductibles, co-payments and co-insurance. After these are paid, the insurance company pays benefits at 100 percent.

Outpatient care (ambulatory care) - Medical testing or treatment done without an overnight hospital stay, performed in a hospital setting or at a doctor's office.

P

Pancreas - A long, irregularly shaped gland that lies behind the stomach and secretes enzymes into the small intestines to aid in the digestion of proteins, carbohydrates and fats. Islet cells within the pancreas consist of four types. The alpha cells secrete glucagons, which raise blood sugar levels. The beta cells secrete insulin, which lowers blood sugar levels. If the beta cells fail, the individual becomes diabetic and may need to take insulin. The pancreas and the islet cells can be donated and transplanted.

Panel Reactive Antibody (PRA) - This is a blood test used to find out how a potential organ recipient will react to a donor organ. A patient with a PRA of 80 percent will likely reject 80 percent of donor kidneys. Patients with a high PRA. have priority on the waiting list. The more antibodies in the recipient's blood, the more likely the recipient will react against the donor organ. For example, patients who have received multiple blood transfusions are likely to have more antibodies in their blood and a higher PRA.

PCO2 - A blood gas test is performed to measure the amount of C02 in the blood. When the lung’s ability to exchange oxygen and C02 becomes impaired, the PC02 level may become increased. The candidate’s current PC02 and change in PC02 are both considered in the lung allocation score calculation to reflect worsening PC02 values. PCO2 is used in the Lung Allocation Score.
 

Peritoneal dialysis - A treatment technique for kidney failure that uses the patient's own body tissues inside of the (abdominal cavity to act as a filter. The intestines lie in the abdominal cavity, the space between the abdominal wall and the spine. A plastic tube called a "dialysis catheter" is placed through the abdominal wall into the abdominal cavity. A special fluid is then flushed into the abdominal cavity and washes around the intestines. The lining (peritoneum) of the abdominal cavity and of intra-abdominal organs act as a filter between this fluid and the blood stream. By using different types of solutions, waste products and excess water can be removed from the body through this process.
 

Plasmapheresis - A process in which plasma is removed from blood and the remaining components, mostly red blood cells, are returned to the donor. The process may be used in transplantation to remove pre-formed antibodies.

Pool - A group of people or objects with a similar characteristic or function.

Potential transplant recipient - A transplant candidate who has been ranked by the OPTN computer match program as the person to whom an organ from a specific deceased organ donor is to be offered.

Pre-authorization (pre-certification) - The process of notifying and getting approval from your insurance company before you proceed with an elective (non-emergency) medical procedure. If your insurance plan requires pre-certification and you do not obtain it, your share of the cost will be higher.

Pre-existing condition - A disease, illness, sickness, or injury considered to be a condition requiring medical treatment that existed before the effective date of a health insurance contract. If a condition is pre-existing, it may not be covered for a specific period of time or covered at all under some contracts.

Preferred provider organization (PPO) - A group of hospitals or physicians who have signed a contract with a particular insurance company to provide care to their members, usually at a discount. If you have a PPO insurance plan, your share of the cost is usually lower if you use one of the designated providers.

Premium - Amount paid to an insurance company for providing medical or disability coverage under a contract.

Private health plan - An insurance policy obtained by an individual, not through an employer.

Procurement - The surgical procedure of removing a donated organ or tissue.

Pulmonary - Having to do with, or referring to, the lungs.

R

Race - See Ethnicity.

Recipient - A person who has received a transplant

Recovery or retrieval - The garnering or removing an organ or tissue from a donor.

Rejection - When the body attacks a transplanted organ or tissue because it reacts to the organ or tissue as a foreign object.  Anti-rejection (immunosuppressive) drugs help prevent rejection.

Renal - Having to do with or referring to the kidneys.

Required Request - Hospitals must tell the families of suitable donors that their loved one's organs and tissues can be used for transplant. This law is expected to increase the number of donated organs and tissues for transplantation by giving more people the opportunity to donate.

Retransplantation - Due to rejection or failure of a transplanted organ, some patients receive another transplant after having returned to the waiting list.

Retrieval - The surgical procedure of organ recovery. Also referred to as procurement.

Risk pools - High-risk health insurance plans called risk pools, have become an important safety net for individuals who are denied health insurance because of a medical condition. About 30 States operate risk pools to provide health coverage for individuals who, because of their physical condition, are unable to purchase health insurance at any price.

Routine referral - When death is declared or about to happen, hospitals are required to call the OPO in order to determine suitability for organ, eye and tissue donation. The OPO, in consultation with the patient's attending physician or his or her designee, will determine the suitability for donation.

S

Scientific Registry of Transplant Recipients (SRTR) - In 1987, Congress passed the National Organ Transplant Act that mandated the establishment of the Organ Procurement and Transplantation Network and SRTR. The purpose of the SRTR is to provide ongoing research to evaluate information about donors, transplant candidates and recipients, as well as patient and graft survival rates. The SRTR contains historical data from October 1, 1987 to the present. The registry tracks all transplant patients from the time of transplant through hospital discharge, and then annually or until graft failure or death. Arbor Research Collaborative for Health operates the SRTR under contract with the Federal Government.

Second opinion - A medical opinion provided by a second physician or medical expert after one physician has provided a diagnosis or recommended treatment to an individual.

Sensitized - Having antibodies in the blood, which means a potential recipient will react against a greater number of potential organ offers. Sensitization usually occurs because of pregnancy, blood transfusions or a previous organ transplant. Sensitization is measured by panel reactive antibody (PRA). A highly sensitized patient is more likely to react against an organ and, therefore, has a smaller pool of potential organs that he/she may receive.

Side effect - An unintended reaction to a drug.

Social Security Administration - A Federal Government program best known for its retirement benefits. The Social Security Administration also administers disability benefits. Your salary and the number of years you have been covered under this program determine the amount of your monthly benefit.

Spend down - For disabled people who have higher incomes but cannot pay their medical bills. Under this program, a person pays part of his or her monthly medical expenses (the spend down),then Medicaid steps in and pays the rest. Eligibility is determined on a case-by-case basis.

Status - A code number used to indicate the degree of medical urgency for patients awaiting heart or liver transplants, such as Status 1, Status 2 or Status 3, with Status 1 being most urgent.

Steroids - Naturally occurring substances, such as hormones, found in the body that helps control important functions. Synthetic or manmade steroids can be used to suppress your immune system.

Supplemental policy (Medigap policy) - An insurance policy offered by private insurance companies, not the Government, designed to pay for some of the costs that Medicare does not cover. These policies have limited coverage for medicines.

Survival rates - Survival rates indicate what percentage of patients are still living or grafts (organs) still functioning after a certain amount of time. Survival rates are used in developing organ allocation policy. Because survival rates improve with technological and scientific advances, policies that reflect and respond to these advances are expected to improve survival rates.

Systolic blood pressure - The top number in your blood pressure (the 120 in a blood pressure of 120/80). It measures the maximum pressure exerted when the heart contracts.

T

Termination of benefits - Health insurance benefits stop when an individual has reached the lifetime maximum amount or when an individual is no longer eligible for the plan due to nonpayment of premiums or leaving his or her job.

Thoracic - Referring to the heart, lungs or chest.

Tissue - An organization of similar cells that perform a special function. Examples of tissues that can be transplanted are blood, bones, corneas, heart valves, ligaments, veins and tendons.

Tissue typing - A blood test that helps evaluate how closely the tissues of the potential donor match those of the recipient.

Transplant, transplantation - To transfer a section of tissue, as section of an organ, or a complete organ from its original position to a new position, for example, to transfer a healthy organ from one person's body to the body of a person in need of a new organ.

Transplant candidate - An individual who has been identified as medically suited to benefit from an organ transplant and has been placed on the waiting list by the transplant program.

Transplant physician - A physician who provides nonsurgical care and treatment to transplant patients before and after transplant.

Transplant program - A component within a transplant hospital that provides transplantation of a particular type of organ.

Transplant recipient - A person who has received an organ transplant.

Transplant surgeon - A physician who performs transplants and provides surgical care to transplant recipients.

U

Uniform Determination of Death Act (UDDA) - The 1981 Uniform Determination of Death Act is a model statute defining "brain death." Versions of this Act have been adopted in 39 states and the District of Columbia. The act states that an individual who has sustained either (a) irreversible cessation of circulatory or respiratory functions or (b) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.

United Network for Organ Sharing (UNOS) - A non-profit organization that administers and maintains the Nation's organ transplant waiting list under contract to the Health Resources and Services Administration of the U.S. Department of Health and Human Services. Located in Richmond, Virginia, LINOS also brings together medical professionals, transplant recipients and donor families to develop organ transplantation policy for the OPTN.  As contractor since the first OPTN contract award in 1986, UNOS has established and continually strives to improve tools, systems and quality processes that support OPTN contract objectives and requirements. These include:

• Managing the national organ transplant waiting list

• Collecting, managing and reporting of sensitive clinical data in a secure, fail-safe environment

• Facilitating an open, inclusive forum for development and continuous refinement of evidence-based policies and standards

• Member and policy performance assessment to ensure equitable, safe treatment of candidates and recipients

• Increasing donation and making the most of every organ that is donated through professional education, outcomes research, patient services and resources and public and professional education

• Continuously improving the care, quality of life and outcomes of organ transplant candidates and recipients

Usual and customary (U&C) fee - The fee that providers of similar training and experience charge for a service in a particular geographical area. If your provider charges more than the U&C fee, your insurance might only pay up to the U&C amount and you might be responsible for the rest of the fee.

V

Varices (esophageal) - Swollen veins at the bottom of the esophagus, near the stomach---a common condition caused by increased pressure in the liver. Varices can ulcerate and bleed.

Vascular - Referring to blood vessels and circulation.

Ventilator - A machine that forces air into the patient's respiratory system when the patient is not able to breathe properly.

Virus - A group of tiny infectious organisms that can grow and reproduce themselves only while living within cells of the body. After reproduction, the new viruses look for new cells to enter.

W

Waiting list - After evaluation at the transplant center, a patient is added to the national waiting list by the transplant center. Lists are specific to each organ type: heart, lung, kidney, liver, pancreas, and intestine. Each time a donor organ becomes available, the OPTN/UNOS computer generates a list of potential recipients based on factors that include genetic similarity, blood

type, organ size, medical urgency and time on the waiting list. Through this process, a new list is ^generated each time an organ becomes available that best matches a patient to a donated organ.

Waiting period - A period of time when you are not covered by insurance for a particular problem, such as a pre-existing condition.

X
Xenograft - An organ or tissue procured from an animal for transplantation into a human.