Screening Reference Guide TISSUE CALCULATOR • •

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Click the Referral tab in TrueNorth > Click the Clinical Data tab > Scroll to the bottom and click the Tissue Screening button Click the Calculate button to show the processors and tissue that the patient is eligible for o NOTE: This page cannot be calculated without age, sex, DOB, and weight of donor. You can run the calculator without height, however there are some height restrictions with tissue, so it is preferred that you have it. Each box in the Tissue Calculator specifies a specific type of tissue recovery. Within each box is a list of processors. The list is in order of priority for screening. If a processor is underlined, scroll over the name and you will find a note with specifications. DO NOT ASSUME THE NOTES ARE THE SAME ON EVERY DONOR AS THEY ARE NOT AND WILL CHANGE BASED ON ELIGIBILITY AND DONOR INFORMATION. There are three types of bone recovery: Bone with ViviGen, Standard Bone, and Limited Bone. o Bone with ViviGen takes priority (check underlined criteria as it may tell you to go to another processor). This type of recovery REQUIRES tissue AOC approval due to the extensiveness of the recovery. o Second priority is Standard Bone (again, check underlined criteria). o Last priority is Limited Bone. Always attempt to keep skin with the selected bone processor, if possible. (This may mean skipping priority on skin and that is okay). Only one type of bone recovery can be recovered. Thus, do not screen with any other bone processors if one processor has already accepted either Vivigen, Standard, or Limited Bone. Pericardium and Costal Cartilage MUST be sent with their respective bone processors. o Example 1: RTI accepted for bone recovery. Pericardium and Costal Cartilage will be sent to RTI, if eligible o Example 2: MTF accepted for bone recovery. Pericardium will not be screened since it only goes to RTI. Costal Cartilage will go to MTF, if eligible. o Exception to the rule: RBI will take Costal Cartilage by itself. Attempt to keep all cardiovascular tissues with the same processor when possible MTN does not recover patients over 375 lbs. for the safety of the recovery team. Saving Sight DOES NOT have this weight limit. If they are the dedicated Eye Bank for the referring hospital, it’s imperative that we pass the referral to them. If donor is only eligible for skin, they must weigh 150 lbs. or more, and be within 60 miles of the Greater Kansas City Metro Area. o Since pericardium, costal cartilage/sternum, and whole globes must accompany other tissue, they are not considered when determining skin-only eligibility.

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If donor is post-autopsy, DO NOT screen for Costal Cartilage, Pericardium, Heart, DTA, AI, or Bone with ViviGen If screening for a Brain-Dead (BD) organ donor, do not screen for Costal Cartilage, Pericardium, DTA, or AI o Exception to the rule: MTF will take Costal Cartilage post organ recovery. Do not screen for Pericardium if donor has a history of heart surgeries.

ALWAYS DOUBLE CHECK THAT YOU HAVE AUTHORIZATION FOR THE TISSUE YOU ARE SCREENING FOR!

HOW TO SCREEN WITH EACH PROCESSOR EYE BANK •

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MTN has several contracted hospitals within the Kansas City Metro Area that allows our tissue team to recover corneas. To figure out who the Eye Bank is, Click the Referral tab in TrueNorth > Click the Preliminary Screening tab > In the first section (Caller Info) there is an auto populated box for Eye Bank that will state if MTN or Saving Sight is the dedicated Eye Bank. You can also click on the down arrow next to the referral number at the top of the screen and it will show in the drop down. Corneas are recovered on ages 2-80 years old Metastatic cancer is NOT an automatic rule out for cornea recovery

• To Screen: o Make sure you are in the referral that you are attempting to screen in TrueNorth. o On the left-hand side, click Referral > Notification ▪ Scroll through ‘Select user(s) to notify:” and check next to Saving Sight Notification. ▪ Add comments to text box including if the case is a shared case or a rule out for tissue donation. • Example 1: Agreement case - need numbers, please • Example 2: Eyes only, Tissue MRO for cancer w/ mets o If MTN is recovering, obtain assigned Processor ID by either calling Saving Sight for follow up or wait for them to call into the DSD. If Saving Sight is recovering, Processor ID is not required. o The Processor ID will always begin with the year, add a hyphen after the year, and end with a unique 4-digit number. (EX: 2023-9189)

MTF • • • • •

Accepts Standard Bone, Limited Bone, Skin, and Costal Cartilage/Sternum Standard bone is recovered on ages 12-55 years old Limited bone is recovered on ages 56-70 years old o Ages 66-70 MS must be sent with dermis to MTF. If no dermis MTF will defer MS. Skin is recovered on ages 15-70 years old Costal Cartilage is recovered on ages 12-60 years old for males and 12-55 years old for females

• To Screen: o Go to https://ereferral.mtf.org/eRefWeb/eRefHome and login (DSD leadership will obtain access for you if you do not have it) ▪ If this site is down, use the phone number (800-992-6630) in the Cisco Finesse system to call MTF and screen verbally. ▪ If you receive an error message, your session may have timed out for staying logged in too long. Attempt to log out and log back in. o Fill in the Required Information and attach a file with TrueNorth Documentation including: • Patient Hospital Information • Clinical Data • NOK/ME/FH • Plasmadilution • Covid-19 • DRAI o Submit e-Referral and an MTF coordinator will call back to review the referral and either accept or decline. Document this call in the Tissue Screening tab along with all necessary details. o A second window will show confirmation of the details and you will have to click Submit a second time to ensure it goes through. o MTF will assign a unique 10-digit Processor ID. (Ex. 0232209212)

RTI • • • • • • •

Accepts Standard Bone, Limited Bone, Skin, Costal Cartilage/Sternum, Pericardium, and Whole Globes Standard bone is recovered on ages 13-55 years old Limited bone is recovered on ages 56-80 years old for males and 56-70 years old for females Skin is recovered on ages 13-80 years old for males and 13-70 years old for females Costal Cartilage is recovered on ages 40-65 years old Pericardium is recovered on ages 40-75 years old for males and 40-70 for females Whole Globes are only recovered when corneas are NOT being recovered. Whole Globes are recovered on ages 40-75 years old for males and 40-70 years old for females

• To Screen: o Call the processor number (877-733-3700) in the Cisco Finesse system to call RTI and screen verbally. o We are allowed to Self-Screen, meaning that if we do not find anything concerning in the clinical and social history, we can screen the case without the confirmation of the RTI coordinator. o We will need to call the RTI coordinator to obtain their internal reference number, and this number will go in the Comments section of the Tissue Screening tab. All other necessary details will go in the Tissue Screening tab, as well. o While RTI does have a unique internal number, we DO NOT use their number as the Processor ID. The processor ID uses our assigned referral number along with “KM” attached to the front. KM stands for Kansas and Missouri (our donor service area). (Example: KM07132022-099)

LIFENET • • • • • • • • •

Accepts Bone with ViviGen, Standard Bone, Limited Bone, Cardiac, Costal Cartilage/Sternum, AI, Femoral Veins, and Saphenous Veins Bone with ViviGen is recovered on ages 12-60 years old for males and 12-50 years old for females Standard Bone is recovered on ages 12-65 years old Limited Bone is recovered on ages 66-70 years old for males ONLY Cardiac minimum age is based on a weight of 8 lbs. or more and the maximum age is 55 years old Costal Cartilage is recovered on ages 12-40 years old AI is recovered on ages 17-30 years old for males and 17-40 years old for females Femoral veins are recovered on ages 17-40 years old Saphenous Veins are recovered on ages 17-55 years old for males ONLY

• To Screen: o Call the processor number (866-727-3365) in the Cisco Finesse system to call LifeNet and screen verbally -ORo Send a secure email to [email protected] with the following information: ▪ Subject: Screening Referral Number, Secure (Ex: Screening 06062222-511 Secure) ▪ Body: • Donor’s first and last name • Agency ID # • Date/Time of Death, Death Type: Asystole, LTKA or Cross-Clamp • DOB, Gender, Race, Height, and Weight • What tissues are being screened? • Is there authorization for research? • Are there restrictions for non-profit use only? ▪ Attachments: • TrueNorth Documentation including: o Patient Hospital Information o Clinical Data o NOK/ME/FH o Plasmadilution o Covid-19 o DRAI o We are allowed to Self-Screen, meaning that if we do not find anything concerning in the clinical and social history, we can screen the case without the confirmation of the LifeNet coordinator.

o We will need to call the LifeNet coordinator if we self-screen to obtain the Processor ID. All necessary information, along with the Processor ID, will be entered in the Tissue Screening tab. o If we send a secure email, the LifeNet coordinator will call back to either accept or decline. Document this call in the Tissue Screening tab along with all necessary details. o LifeNet will assign a unique 7-digit Processor ID. (Ex. 2219828)

CRYOLIFE • Accepts AI, Cardiac, DTA, Femoral Veins, and Saphenous Veins • AI is recovered on ages 15-45 years old for males and 15-55 years old for females • • • •

Cardiac minimum age is based on a weight of 6 lbs. or more and the maximum age is 60 years old DTA is recovered on ages 15-34 years old. DTA is ONLY recovered with AI. Femoral veins are recovered on ages 14-40 years old Saphenous veins are recovered on ages 14-60 years old for males ONLY

• To Screen: o Call the processor number (800-438-8285) in the Cisco Finesse system to call CryoLife and screen verbally o Ask to be transferred to Donation Services if you get the operator o CryoLife will NOT assign a Processor ID until after tissue recovery has taken place o Document all necessary details from the phone call into the Tissue Screening tab, however, leave the Processor ID blank (this will get filled in by the recovery team)

LEMAITRE • • • • •

Accepts AI, Cardiac, Femoral Veins, and Saphenous Veins AI is recovered on ages 15-40 years old Cardiac is recovered on ages 6 months to 60 years old Femoral veins are recovered on ages 15-30 years old for males ONLY Saphenous veins are recovered on ages 15-60 years old for males ONLY

• To Screen: o Call the processor number (918552776776) in the Cisco Finesse system to call Lemaitre and screen verbally o Lemaitre will use our internal reference number as the Processor ID (Example: 07132022-099). o Document all necessary details from the phone call into the Tissue Screening tab.

LIFECELL • • • •

Accepts Skin Skin is recovered on ages 14-90 years old Most active cancers are NOT a rule out for LifeCell; however, metastatic cancer is a rule out. If donor is ONLY eligible for skin, they must weight 150 lbs. or greater

• To Screen: o Call the processor number (888-554-2040) in the Cisco Finesse system to call LifeCell and screen verbally o We are allowed to Self-Screen, meaning that if we do not find anything concerning in the clinical and social history, we can screen the case without the confirmation of the LifeCell coordinator. o LifeCell will use our internal reference number as the Processor ID (Example: 07132022-099). o Document all necessary details from the phone call into the Tissue Screening tab.

RBI • • • • •

Accepts Standard Bone, Limited Bone, Skin and Costal Cartilage Standard Bone is recovered on ages 14-65 years old Limited Bone is recovered on ages 66-80 years old Skin is recovered on ages 14-90 years old Costal Cartilage is recovered on ages 14-65 years old

• To Screen: o Call Bill Cassarly (352-213-1921) in the Cisco Finesse system and screen verbally o We are allowed to Self-Screen, meaning that if we do not find anything concerning in the clinical and social history, we can screen the case without the confirmation of Bill. o RBI will use our internal reference number as the Processor ID (Example: 07132022-099). o Document all necessary details from the phone call into the Tissue Screening tab.

PINNACLE • • •

Accepts Standard Bone and Limited Bone Standard Bone is recovered on ages 12-55 years old Limited Bone is recovered on ages 56-90 years old for males and 56-70 years old for females

• To Screen: o Call Wayne Godsmark (352-514-5303) in the Cisco Finesse system and screen verbally o Pinnacle will use our internal reference number as the Processor ID (Example: 07132022-099). o Document all necessary details from the phone call into the Tissue Screening tab.

TrueNorth Page Procedure – Tissue Screening THIS PAGE WILL NOT ACCURATELY REFLECT PROCESSOR ELIGIBILITY UNTIL THE TISSUE CALCULATOR HAS BEEN CALCULATED Tissue Outcome Tissue Auto-populates from information input in the second section

Processor Auto-populates from information input in the second section

Processor Processor ID Contact Date/Time Contact First Name Last Name No Authorization for UPPER Arm Recovery Tissue Acceptance Comments

Save

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Screening Outcome Auto-populates from information input in the second section

Processor ID Auto-populates from information input in the second section

Select from drop down list Add Processor ID given by selected processor, if applicable Enter the time the phone call for acceptance or decline takes place Enter the first name of the coordinator you spoke to for the selected processor Enter the last name of the coordinator you spoke to for the selected processor Check this box if the family has declined authorization for Upper Arm Recovery Auto-populates after the Tissue Calculator has been calculated Select from drop down list based on processor determination Add any necessary comments or details discussed during the phone conversation. Do not erase other notes, add to them. Saves page

Each processor shall have their own module. To add a new module, click on the + button within the second section. If you need to delete a module, click on the x button within the second section. If you need to scroll between modules, click on the < > buttons within the second section.

Additional Tissues • •

This section is used for specialty grafts. You will be notified by DSD or Tissue leadership if there are specialty grafts being asked for by the processors.

Processor Processor ID Contact Date/Time Contact First Name Last Name No Authorization for UPPER Arm Recovery Tissue Other Tissue Acceptance Comments

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Select from drop down list Add Processor ID given by selected processor, if applicable Enter the time the phone call for acceptance or decline takes place Enter the first name of the coordinator you spoke to for the selected processor Enter the last name of the coordinator you spoke to for the selected processor Check this box if the family has declined authorization for Upper Arm Recovery Select from drop down list If ‘other’ is selected as the tissue above, then type in the specialty graft being recovered Select from drop down list based on processor determination Add any necessary comments or details discussed during the phone conversation. Do not erase other notes, add to them. Saves page

Each processor shall have their own module. To add a new module, click on the + button within the second section. If you need to delete a module, click on the x button within the second section. If you need to scroll between modules, click on the < > buttons within the second section.

Other Case Coordination Journal TPC Notification

Date/Time Untitled Drop-Down List

HSC/Screening Complete Date/Time Untitled gray box

HSC/Recovery Complete Save

Saves page and auto-journals **should always use this after notifying recovery team of new case** Enter the date/time the recovery team has been notified of the case Select person from drop down list that was notified of new case. *Verify first and last name of person* Click this box once screening has been completed Auto-populates time that HSC/Screening Complete button is clicked Auto-populates the HSC for the referring hospital after the HSC/Screening Complete button is clicked Not currently used by the DSD Saves page

Screening Complete – Now What? • • • •

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Confirm all your notes are entered and accurate Notify the recovery team that they have a new case using the Pass to TPC checklist. Notify the hospital that this patient is a consented donor, and our recovery team will be making transportation arrangements Notify the funeral home and/or medical examiner, if applicable, that this patient is a consented donor, and our recovery team will be in contact with them once recovery is complete Notify your team that you are finished screening so that your Shift Leader or another approved coordinator can complete an Authorization/Billing Review to ensure accuracy Update the case status on the Active Referral Grid to reflect screening completion

What do I need to tell the recovery team when I pass a case? •

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Patient Demographics o Age/sex o Hospital or referring facility o Location of patient (morgue, unit, ME, FH, etc.) Authorization Uploaded? o First Person Authorization or NOK authorization o Are there two authorizations o Are there special limitations or requests? o Any concerns with DRAI, authorization or informed disclosure? Screening o What tissue is to be recovered and is it marked appropriately? o Are there any medical issues, DRAI issues, Trauma to areas to be recovered, etc.? Medical Examiner o Is there an ME or Coroner involved? o Are there any restrictions ▪ Pre or Post • Time frames on autopsy ▪ Tissues not to be recovered ▪ Requests made by ME/Coroner (blood, vitreous, etc.) FH Status o Has a FH been chosen, and have they been contacted? o Are there any concerns expressed by funeral home about donation?