FAQs: When familiar with solid organ transplantation

Payors who provide medical coverage for solid organ transplantation often have these questions:

• Are patients who need a hematopoietic cell transplant placed on a waiting list?
• Do you bill the donor’s insurance first?
• Where is the donor’s medical record for the lab charge?

• Are patients who need a hematopoietic cell transplant placed on a waiting list?
• No. The process for a hematopoietic cell transplant is different than for a solid organ transplant. For solid organ transplantation, the patient is selected based on urgency of the patient's need and the availability of a compatible organ. For hematopoietic cell transplantation, the disease status and the patient’s health determine when a transplant is needed. For example, a transplant may be needed as soon as possible, before the patient’s health or disease status changes. Or, it may be needed when the disease is in remission or at a later stage of the disease. Each disease has different factors affecting the timing of the transplant.

  Searching for closely matched hematopoietic cells requires human leukocyte antigen (HLA) testing several unrelated donors or cord blood units. The search process can take weeks or even months. A delay in beginning the search process could prevent the patient from receiving a transplant or having the most effective outcome.

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• Do you bill the donor’s insurance first?
• No. Donors are anonymous.
  
  Volunteers do not incur any costs to donate their marrow or peripheral blood stem cells (PBSC). Volunteer donors join the Registry of the National Marrow Donor Program with the understanding that, if selected, they will need to take time off from their daily schedule to help a person they do not know, but who needs their potentially life-saving hematopoietic cells.

  Before a transplant can be performed, the best matched cells are selected by the transplant physician. Selecting the best matched cells requires HLA testing potential donors and cord blood units.

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• Where is the donor’s medical record for the lab charge?
• When HLA testing is performed during a formal search, there are no medical records or clinic reports for the potential donor. HLA testing is being performed to identify a closely matched donor or cord blood unit.

  When a donor is selected as the best match for the patient, the donor attends an informational session, receives a physical exam and undergoes further HLA testing. When the timing is right for the patient, the volunteer donates his or her marrow or PBSC.
  
  

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