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System notice

Maximum Allowable BMI has increased for Kidney-Pancreas Candidates

Audience
All Kidney and Pancreas Program Staff at Transplant Hospitals

At-a-glance
After a scheduled review of the pancreas/kidney-pancreas allocation policy, we have increased the maximum allowable BMI threshold for accruing kidney-pancreas waiting time from 28 to 30. This review was stipulated by the new allocation policy that was implemented in October 2014. That policy specifies that we will perform this review every six months and make any necessary modifications to the maximum allowable BMI threshold. This change is the result of the first review we conducted after the policy was implemented.

Implementation date
July 15, 2015

More details
Under current policy, one way for your adult (18 years or older at time of listing) kidney-pancreas (KP) candidates to accrue waiting time is as follows: if they are on insulin with a C-peptide >2ng/mL, their BMI must be less than the maximum allowable threshold (Policy 11.4B). The current allowable threshold was 28 kg/m2.

Our six month evaluation of active kidney-pancreas (KP) candidates indicated that only 6% had –peptide>2 and 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 needed to increase the maximum allowable BMI by 2 kg/m2 and notify all kidney and pancreas programs of this increase. Today, July 15, 2015, we increased 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

  • KP Candidates who may not have qualified to accrue waiting time 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 threshold changes or not.
  • Waiting time for your qualified KP candidates begins when the criteria listed in policy 11.4.B are met. You must document when and how your candidate qualified for waiting time.

Contact
If you have questions, contact your UNOS regional administrator at 804-782-4800.

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