Glossary of Terms

Below are definitions of commonly used terms in kidney transplantation. Search the glossary alphabetically or by keyword filter.

#A B C D E F K L M N O P Q R S T U V W X

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30-Day Average Preselect % (Avg Pre-Selected %): The average of the daily percent of pre-selects reviewed by a center for the last 30 days.

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Accepted Percent (Accepted Pct)

The percent of offers made by the NKR to a center that are accepted, divided by the total offers made by the NKR to this center. May be over a specified period of time.

Alias

The name given by the center to refer to each of its patients and donors. Aliases are used to comply with HIPAA laws.

All-In Centers

Member Centers that have instated the “All In” addendum agree to enter all KPD pairs and non-directed donors into the NKR. All In participation allows the NKR to facilitate the maximum number of transplants possible at all NKR Member Centers to the benefit of their patients.

Average Wait Time (Avg Wait)

Average wait for a patient who received or is waiting to receive a transplant. Unless indicated, listed values are rounded to the nearest month.

Average Wait Time for a Paired Recipient in Months (Avg Paired Wait)

Average wait of a paired patient. This measurement can either be for a transplanted patient or one awaiting transplant in the NKR system. Unless stated otherwise, this timespan is measured to the nearest month asuming the average month to have 30.4375 days.

Avoidable Swap Failures

Swap failures caused by centers that could have been avoided by following proper protocols.

Avoids

Avoids are antibodies of significance. If a patient has 10 avoids, they have 10 antibodies of significance.

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Bridge Donor (BD)

A paired donor who donates after their paired recipient has already received a kidney.

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Center

Transplant center or hospital.

Center Liquidity Contribution (CLC)

Scores Member Centers based on their contribution to the pool liquidity (i.e., NDDs, vouchers, and pairs entered) and the “payback” of the center’s contribution (hard to match pairs matched and transplanted) in the form of match offers. Note: Top scoring CLC centers are given priority.

Center to Center Billing (CCB)

Seamless centralized billing within the NKR network.

Chain

A series of one or more transplants initiated by a Good Samaritan or voucher donor.

Chain End Decline Ratio

Total chain end offers divided by total chain end declines.

Challenging Logistics

Every logistics plan that involves deviation from the center-specified time frames of kidney pick up and delivery is considered “challenging logistics.”

Charter Hybrid

A connecting flight plan that involves both a commercial and charter flight, in no particular order.

Children & High cPRA Patient (CHIP)

Qualifying patients are in the NKR system with no paired donor. Chains started by NDDs will be ended to CHIP patients at centers that are at least +1 NCS. (The CHIP program is no longer active and has been replaced with WLP.)

Clust #

Transplant chains are extended by groups of simultaneous or near-simultaneous transplants. These groups are referred to as clusters and given sequential numbers within the chain to which they belong. Clusters are assigned when utilizing bridge donors.

Cluster

Transplant chains are extended by groups of simultaneous or near-simultaneous transplants. These groups are referred to as clusters. Clusters are assigned when utilizing bridge donors.

cPRA

cPRA represents the proportion of the population to which the patient will react adversely due to the patient’s pre-existing antibodies. The value provided (between 0 and 100) refers to the average value for NKR-arranged transplanted patients.

Crossmatch (XM)

Tests the compatibility of a donor’s and a recipient’s blood or tissue.

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D

Typically, if a word if prefaced with “D” that stands for “donor.”

D Age ATOT

Donor age at time of transplant, i.e., at time of donation.

D Alias

The name given by the transplant center for a given donor. Aliases are used to comply with HIPAA laws.

Delayed Graft Function (Delayed Function)

Delayed function occurs when a transplanted kidney does not immediately produce urine when transplanted.

Deleted

The date a donor or patient is removed from the NKR system before a transplant has been arranged by the NKR. If a donor or patient is involved in an NKR transplant, they are not deleted.

Directed Donor (DD)

Stands for “directed donor,” which is a donor paired to a patient who needs a kidney transplant.

Donor ABO (D ABOs)

Blood types of donor pairs. For multiple donors/patient, values are pipe-delimited, e.g., A|O|B.

Donor Automated Screening & History (DASH)

A comprehensive, online living donor workflow platform designed to streamline the processes related to intake screening for living kidney and living liver candidates through to post-donation follow-up. **Please contact your NKR liaison for additional questions or to have this tool turned on for your center.

Donor Care Network Centers (DCN)

Donor Care Network Centers are a group of high-performance transplant centers that have agreed to an extensive list of guidelines and commitments to go above and beyond for living donors to provide the highest level of care, protection and support to living donors and their families.

Donor Center (D Center)

The transplant center where the donor will get the nephrectomy done.

Donor Clearance

Once all positions in a swap are accepted, the NKR will commence crossmatching and donor record review. Donor Clearance refers to the donor record review, where you will have to clear the donor to donate to your patient by marking the donor as “Donor Cleared & XM Acceptable” within the evaluate match page. This means you have reviewed the donor records, XM, etc.

Donor Complications

Donor complications that arise after the donor nephrectomy that are a direct result of the surgery.

Donor Connect

A system that allows donors to communicate with NKDO counselors (donor mentors) who can help answer questions regarding the donation process.

Donor Evaluation Billing (DEB)

Details can be found in NKR’s terms & conditions.

Donor Match Power (DMP)

Each ‘one-way’ is a transplant from a donor to a patient who are tissue compatible, and the NKR’s matching software combines one-ways into ‘clusters’. The higher the DMP, the more likely the donor paired to the patient will bring the patient into a cluster. DMP is calculated as the percentage of unmatched recipients (exclusive of WLPs) in the NKR pool with whom the donor is both tissue compatible and preference compatible, times 100.

Donor Protection Addendum

An addendum between a Member Center and the NKR stating that the Member Center agrees to cover all uncovered donor complications for NKR donors who undergo donor surgery at the Member Center’s hospital

Donor Record Review (DRR)

A DRR is triggered to a recipient center due to either a donor who hasn’t been reviewed in pre-selects or was accepted as not fully confident.

Donor Referrals

All donors referred to transplant centers through the NKR are eligible to be protected by Donor Shield.

Donor Shield Direct Centers

Donor Shield Direct is a version of Donor Shield that centers can buy for their direct kidney donations. This program offers the same coverage that Donor Shield does.

Donor Workup

A CCB System – the NKR automatically bills the workup to the recipient center for all chain starters and remits back to the donor center.

Duty Officer (DO)

An NKR logistics coordinator assigned to monitor and track moving kidneys for both the assigned donor and recipient centers. For any questions regarding a moving kidney, please email or call the current officer on duty as shown on your swaps page.

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Eplet Mismatch: A comparison between a donor’s and recipient’s eplet analysis.
Erosion %: Erosion is the effect of a patient’s preferences on their likelihood of being transplanted via the NKR. For instance, let’s assume a patient is tissue-compatible with 110 donors in the NKR system. Now let’s assume that this patient is only willing to accept a kidney from someone 50 years of age or younger. If this is the patient’s only preference requirement and 85 of these 110 donors are 50 or younger, then this patient’s erosion is 23% ((110-85)/110).
Exportable (Exportable Participants): Patients waiting for a transplant and donors are deemed exportable when there is nothing that would prevent them from being assembled into transplant NKR clusters. A patient who is currently too sick to be transplanted and a donor who is awaiting medical workup are examples of participants who are NOT exportable.

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Family Voucher (ADP-FV)

When a donor donates according to their schedule while providing up to five vouchers for their family members who are not in imminent need of a transplant.

FAST Track Match Offers

Match offers made with surgery dates within three weeks of the offer date.

Favorable Blood Type Combination

Paired donor blood type “O” and recipient blood type of either “A,” “B” or “AB.”

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KFL Internal Direct: A compatible pair that generally has a low eplet mismatch that cannot upgrade to a better eplet mismatch.

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Logistics Provider (Courier): Who provided transportation for a shipped kidney.
Loop: A traditional paired exchange that is two pairs or more, no NDD is needed to start the chain and the end does not go to a WLP.
Lost Wage Reimbursement (LWR): A Donor Shield reimbursement protection that reimburses donors up to six weeks, maximum $2,000 per week, with no income cap. Donor must donate through an NKR exchange or through a participating transplant center’s Donor Shield Direct program.

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Match Offer Accept

Whether a recipient transplant center has accepted the NKR’s offer to transplant their patient.

Maximum Donor Age Preference (MDA)

The maximum age of a donor from whom the patient is willing to accept a kidney.

Member Centers

All transplant centers that agree to work with the NKR are Member Centers. This is the base level of participation.

Microsites

A professional platform to allow patients to share the story as to why they need a kidney. **Please contact your NKR liaison for more details or to have this feature turned on for your center.

Minimum HLA Points (MHP)

Points are assigned in accordance with how tissue compatible a patient and a prospective donor are. Patients have the option of specifying minimum points.

Mtchd Pairs

The number of paired patients whose center has accepted an NKR match offer for them but have not yet been transplanted.

Mtchd Rs

The number of patients whose center has accepted an NKR match offer for them but have not yet been transplanted.

Mtchd Rs %

The ratio of patients at a center who are involved in an NKR match offer but not yet transplanted to the patients at the same center who have not been accepted in a match offer.

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Net Chains Started (NCS)

The number of NDDs who have started chains at a particular center minus the number of WLP patients the center has transplanted.

Neutral Blood Type Combination

Blood type other than “favorable” or “unfavorable.”

NKR cPRA

For a given patient, (the number of exportable donors in the system whose antigen profile poses no transplantation concern because of patient avoids/the total number of exportable donors in the system) * 100, rounded to the nearest integer.

Non Directed Donor (NDD)

A donor that is not paired with a patient. Also known as a Good Samaritan donor.

Non-Blckd PrePref OWs

Non-blocked pre-preference one-ways. A one-way is a potential transplant. Values under this heading are counts of one-ways for the center that have not been blocked (pre-rejected) by the center.

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Offered: When a match was offered to transplant centers.
On-Board Courier (OBC): Two connecting commercial flights generally require an on-board courier, which is a person that carries the kidney onto the plane instead of tendering the kidney into cargo.

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Pair Match Power (PMP)

PMP (Pair Match Power) is calculated by multiplying the recipient match power (RMP) by the donor match power (DMP) then adding RMP to the product. The basic formula for PMP is (RMP x DMP + RMP). PMP may be calculated based on pre-preference RMP (RMPa) or post-preference RMP (RMPb). The toolbox displays both of these results. The formula for PMP, when more than one DD is included in the pair, is expanded to reflect the DMP of the additional donor(s). The basic formula is: PMPb = (RMPb x DMP) = (RMPb x 1,000).

Pair Status

Pair status is a number from 1 to 5 indicating where a patient or donor is in the transplant process. For instance, a patient waiting for an offer has a status of 1 while a patient having received a transplant has a status of 5. 1-No Match, 2- Match Offer, 3-Pending XM, 4-Pending Transplant, 5-Transplanted

Pairs

The number of paired patients in the NKR system. Generally, only pairs in status 1 are counted (see above for status definition).

Partner Centers

Partner Centers are designated to absorb the chain end kidneys resulting from the Voucher Program. Partner Centers are active Voucher Program participants, adhere to the “All In” addendum and commit to accept any chain end offer (within reason) from the NKR.

Patient Referrals

Patients without donors can now choose to refer themselves to microsite participating centers.

Pending

The number of outstanding transplant offers a center has yet to respond to.

Percent of Pre-Selects Reviewed on a 30-Day Average (Avg % Reviewed)

The average of the daily percent of pre-selects reviewed by a center for the last 30 days.

Percent of Pre-Selects Reviewed on a 30-Day Average (Avg % Reviewed)

The average of the daily percent of pre-selects reviewed by a center for the last 30 days.

PMPa

Pair Match Power (PMP) is calculated by multiplying the recipient match power (RMP) by the donor match power (DMP) then adding RMP to the product. The basic formula for PMP is (RMP x DMP + RMP). PMP may be calculated based on pre-preference RMP (RMPa) or post-preference RMP (RMPb). The toolbox displays both of these results. The formula for PMP, when more than one DD is included in the pair, is expanded to reflect the DMP of the additional donor(s). The basic formula is: PMPb = (RMPb x DMP) = (RMPb x 1,000).

PMPb

Position (Pos)

In a transplant cluster, each transplant is numbered sequentially from one to the number of transplants in the cluster.

Post-Preference RMP (RMPb)

The percentage of VEDs in the NKR pool that match a given recipient after the introduction of any preferences and hard blocks. For example, if a patient is both tissue and preference compatible with 17 VEDs in a pool of 235 donors, RMPb is 0.0723 (17/235).

PostPref OWs

How many one-ways (transplant donations) there are after preferences are factored. Generally applies to potential transplant operations used to assemble clusters during a run of the NKR’s matching software.

Pre-Preference RMP (RMPa)

The percentage of VEDs in the NKR pool that match a given recipient prior to the introduction of any preference restrictions. For example, if a patient is tissue compatible with 21 VEDs in a pool of 235 exportable, the RMPa for that patient is 0.0894 (21/235).

Pre-Select

Potential donors for each recipient who appears in the pre-selects. Centers must accept or decline these pre-selected donors for their recipient, which will influence match offers and increase match offer efficiency.

Pre-Select Fully Confident (Fully Confident)

When a recipient center is fully confident to accept a potential donor for their recipient.

Pre-Select Not Fully Confident (Not Fully Confident)

This only refers to the Virtual XM (VXM). If a recipient center is “not fully confident” with a potential donor for any other reason, it is recommended that the recipient center “decline” the donor until they can accept as fully confident.

Pre-Select Reversal

When a recipient center declines a match offer due to pre-selects for a donor that was previously accepted in pre-selects.

Preference

Includes all non-biological settings that can block a match, including maximum donor age, minimum HLA match points and hard block or declines set via the donor pre-select function.

Preferred

Based on donor’s age and HLA points, which is set in the “toolbox” found in the recipient’s profile.

PrePref OWs

How many one-ways (transplant donations) there are ignoring patient preferences.

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Qty Accepted: The number of transplant clusters offered by the NKR that were accepted by a center.
Qty Late: The number of transplant clusters offered by the NKR that were responded to after the response deadline by a center.
Qty No Responses: The number of transplant clusters offered by the NKR that were NOT responded to by a center.

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R ABO

Patient blood type.

R Age ATOT

Patient age at time of transplant.

R Alias

The name given by the center to refer to each of its patients. Often needed to comply with HIPAA regulations.

R Center

The center of a given patient.

R Insurance

The patient’s insurer.

Real-Time Swap Failure (RTSF)

Occurs when a patient is left without a paired donor kidney.

Recipient (R)

Stands for recipient. Synonymous with patient.

Regular Swap Failure

Occurs when a swap falls apart after crossmatching has commenced.

Remote Direct

Occurs when a donor is donating directly to a patient in need of a kidney instead of through paired donation. The donor donates at a participating NKR center closer to their home.

Remote KPD

Occurs when a donor donates their kidney on behalf of another person in a paired exchange. The donor donates at a participating NKR center closer to their home.

Remote Standard Voucher

Occurs when a donor donates their kidney in advance on behalf of a loved one who is at a different participating NKR center in a distant city.

Reviewed %

The center’s rate of reviewing NKR pre-selects.

Root Cause Corrective Action Plan

Step-by-step plan of action to define, analyze and prevent a problem from reoccurring in the future.

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Serologies

A donor blood test that identify antibodies in a patient’s blood to prevent a donor from transmitting any diseases.

SLOW Track Match Offers

Offers made six or more weeks out.

Standard Voucher (ADP-SV)

When a donor can donate according to their schedule while providing a voucher for their friend or family member who is in imminent need of a transplant. The voucher can be redeemed when the listed voucher holder (friend or family member) is ready for transplant surgery.

Streamlined Billing Service (SBS)

A CCB System – Automated billings of workup, professional and facility fees, used for remote direct donation and if center is SBS eligible (only Walter Reed), and remits back to donor center.

Streamlined Hospital Billing (SHB)

A CCB System – Donor center bills recipient center for professional and/or facility fees.

Streamlined Serologies

Lowers the donor center’s costs since tests are billed to the recipient center for inclusion on the Medicare cost report, in accordance with CMS regulations.

Swap

NKR-assigned number for an offered transplant cluster.

Swap Manager (SM)

An NKR operations employee tasked with bringing an assigned swap from the beginning to the end – kidney(s) are delivered to the recipient center(s).

Swap Saver (SS)

A voucher type where the paired donor proceeds with the donation to keep the rest of a swap on schedule, but their paired recipient does not receive a transplant in the swap.

Toolbox: A recipient preference (optional) that a center can set to decline donors who are not yet accepted or declined in pre-selects for a specific recipient. The NKR would not send a match offer unless the center accepts the donor in pre-selects. Note: this feature does not take into account the loop system.
Transplanted Participants: Transplanted patients of all types.
Transplants: The count of transplanted patients of all types. Take in context. May refer to a certain timespan.
Travel & Lodging Reimbursement (TLR): A Donor Shield reimbursement protection that reimburses up to $5,000 for donors and a caregiver. Donor must donate through an NKR exchange or through a participating transplant center’s Donor Shield Direct program.

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Unfavorable Blood Type Combination: Paired donor blood type of either “A,” “B” or “AB” and a recipient blood type of “O.”
Universal Bill Pay (UBP): A CCB System – Allows an NKR recipient center to pay an NKR donor center through the NKR system for invoices they receive from donor centers who did NOT use SHB.
Unmatched Pairs (UnMtchd Pairs): Stands for unmatched pairs. Pairs are patients in the NKR system with paired donors.
Unmatched RS (UnMtchd Rs): Stands for unmatched recipients. An R is any type of patient in the NKR system.
UNOS cPRA: The UNOS-provided value for a patient’s cPRA.

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Viable Exportable Donor ( VED)

A donor is viable when they match a given recipient and when the donor is paired with a recipient that has an RMPb score greater than 0. When a donor is connected to a recipient with a RMPb score of 0, they are unmatchable and that donor is not available to match other recipients in the pool and is therefore not viable.

Voucher Donor

A paired donor who donates prior to their paired recipient receiving a kidney.

Voucher Education Module (VEM)

A powerful and valuable tool in DASH that automatically educates all donor candidates online about the advantages and options of voucher donation early in the process while going through the DASH donor intake process.

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Wait Time: The wait to date of a patient yet to have a transplant facilitated by the NKR or length of time it took for the NKR to facilitate a transplant for a transplanted patient. Unless otherwise stated, wait time is expressed to the nearest month.
Waitlist Patient (WLP): Waitlist patient. When a voucher holder cannot be matched at the end of a chain, the NKR will assign a qualifying center to choose a WLP from their deceased donor list to accept the living kidney donor at the end of the chain.

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Xplant Date (XP Date): The date of the transplant.