After a scheduled review of pancreas policy, the maximum allowable BMI for a candidate’s listing is being increased. This review was stipulated by the new pancreas allocation policy that was implemented in October 2014.
Apart from listing criteria, current policy dictates that any adult kidney-pancreas candidate (18 years or older at time of listing) with diabetes and C-peptide >2ng/mL must have a BMI less than the maximum allowable threshold (Policy 11.4B). The current allowable threshold is 28.
Our six month evaluation of active candidates indicated that only 6% met the maximum BMI threshold (criterion 3b in Policy 11.4B). According to policy, if the percent of candidates meeting this criterion is less than 10%, we need to increase the maximum allowable BMI by 2 kg/m2 and notify all kidney and pancreas programs of this increase. Consequently, we will soon be increasing the maximum allowable BMI to 30. Read Policy 11: Allocation of Pancreas, Kidney-Pancreas, and Islets for complete language and criteria for listing and waiting time.
What this means for your transplant program
- Candidates who may not have qualified to be listed before, a candidate with a BMI of 29, for example, may now qualify.
- Once your kidney-pancreas candidate qualifies for waiting time, that candidate will remain qualified whether the maximum allowable BMI changes or not.
- Waiting time for your qualified candidates begins when they qualify for waiting time, according to policy. You must document when and how your candidate qualified for waiting time.
This system change should be effective by early July. We will inform you of its implementation by posting a system notice on the homepage of UNet and also alerting you through UNOS Tech News.