Activation Milestone

I have been “listed” for sometime but all that really means is that you are being monitored and tracked by UNOS (www.unos.org) and submitting lab test at the prescribed interval. You are not actually “waiting for a call.” Activation requires another round of testing to ensure no major changes in the health of you respiratory, cardiovascular or other major organ groups. It includes tests for potential infection sources including dental (only sound teeth pass, teeth with decay or prior root canals have to be extracted). Once activated activated you are “waiting for the call.” Ultimately allocation is based on a combination of factors that include; location of the donor, size of the organ, provenance of the organ and the MELD score of the recipient.

Today I received a registered later from UNOS telling me that my status had been changed “active”.  It also outline the criteria for lab test and test frequency based on MELD score.  Today my MELD is at 18 so I will continue with monthly lab tests.  When my MELD score reaches 25 I will need weekly lab test and UNOS will need be updated within 3 days of the test.  Finally when or if my MELD score exceeds 32 I will need daily blood test and UNOS will need to be update within 48 hours of each test.  If my MELS score reaches or exceeds 40 (the ceiling) then my physicians can petition UNOS to have me declared a 1A status, this status is for 7 days at which point it would need to be petitioned again.  The 1A status is for the most critical patient that have the greatest mortality risk and allows for a broader allocation of organs for these patients than the standard allocation process.

While I am now “waiting for the call” I know that it is likely not to happen soon.  The average MELD score of patient at transplant at Mayo is in the low to mid 30′s.  So I won’t hold my breath but continue to wait.