Utah Administrative Code
Topic - Health
Title R414 - Integrated Healthcare
Rule R414-10A - Transplant Services Standards
Section R414-10A-7 - Solid Organ Transplantation, Covered Services and Requirements
Universal Citation: UT Admin Code R 414-10A-7
Current through Bulletin 2024-06, March 15, 2024
(1) The following solid organ transplant services are covered. Minimum requirements for specific transplant services are shown. As required by 42 CFR 482, Subpart E, each transplant center must also have written selection criteria.
(2) All patients must be free of active infection. Liver transplants are excepted as noted.
(3) Liver.
(a) The patient must:
(i) have progressive, irreversible liver
disease requiring transplant;
(ii)
be free from active infection outside the hepatobiliary system;
(iii) not have acute, severe hemodynamic
compromise at the time of transplantation if this compromises non-hepatic
end-organs;
(iv) be free from
significant pulmonary disease;
(v)
be free from any significant cardiovascular disease; and
(vi) not have stage IV hepatic coma.
(4) Cornea.
(a) The patient must be free of other
associated disease that may preclude visual improvement with transplant.
(5) Cardiac.
(a) The patient must:
(i) have irreversible and progressive cardiac
disease with a life expectancy of one year or less without transplant or
progressive pulmonary hypertension without other treatment options; and
(ii) be free from significant
pulmonary disease, except pulmonary hypertension.
(6) Intestine.
(a) The patient must:
(i) have short bowel syndrome or irreversible
and progressive small bowel disease requiring daily hyperalimentation without
reasonable alternatives;
(ii) be
free from significant pulmonary disease; and
(iii) be free from significant cardiovascular
disease.
(7) Kidney.
(a) The patient must:
(i) have irreversible, progressive end-stage
renal disease;
(ii) not have
acute, severe hemodynamic compromise at the time of transplantation if this
compromises non-renal end-organs;
(iii) be free from significant pulmonary
disease; and
(iv) be free from any
significant cardiovascular disease.
(8) Lung.
(a) The patient must:
(i) not have acute, severe hemodynamic
compromise at the time of the transplantation if this compromises non-pulmonary
end-organs;
(ii) be free from
significant cardiovascular disease; and
(iii) demonstrate abstinence from tobacco use
within the last 6 months.
(9) Pancreas.
(a) The patient must:
(i) have type I diabetes mellitus;
(ii) not have acute, severe hemodynamic
compromise at the time of the transplantation if this compromises end-organs;
(iii) not have active peptic ulcer
disease;
(iv) be free from
significant cardiovascular disease; and
(v) be free from significant pulmonary
disease.
(10) Multi-organ transplants.
(a) Kidney/pancreas, liver/kidney,
cardiac/lung, intestine/liver, and other multi-organ transplants may be
considered;
(i) each case is reviewed
individually as to medical necessity and appropriateness; and
(ii) complete documentation, including
justification and outcomes, must be provided.
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