http://transplantpro.org/region-1-fall-2013-meeting/

Region 1 Fall 2013 Meeting

September 30, 2013 — Westborough, MA
Contact: Shannon Edwards at shannon.edwards@unos.org or 804-782-4759 if you have questions.
Meeting Information
Agenda
Public Comment Proposals
Executive Summary from the June 2013 OPTN/UNOS Board Meeting

I'll be there, will you?

See you tomorrow morning?

Our Associate Regional Councilor, Dr. David Hull, died of lymphoma in February. Dr. Elizabeth Pomfret agreed to continue as Councilor through 2013-2014, pending election of a new Associate Councilor, to become Councilor in 2014.

OPTN/UNOS President Dr. Kenneth Andreoni gave the UNOS update. (I've known Ken for years now as he's been central to the kidney allocation and kidney paired donation pilot program efforts.)

-> Kidney Allocation: Board approved revision in June 2013. Rollout timetable means intensive prep of transplant center staff and data entry starting in mid 2014. Actual computer changeover and start of new allocation now scheduled for mid to late 2015.

-> KPDPP: Has been privately financed to date. These funding sources expected to end by mid 2014. Plan going forward not clear yet.

-> Tracking (of all tissues): Completeness very consistent.

-> Pediatric Lung Allocation: Policy reviews in progress, proposals for public comment expected for spring 2014.

-> Geographic Distribution: Getting some hard data and redistricting proposals in the literature, i.e.: "Addressing Geographic Disparities in Liver Transplantation Through Redistricting," Gentry, et al., American Journal of Transplantation Volume 13, Issue 8, pages 2052–2058, August 2013

-> Last 1.5 years no OPTN contract, now signed, just in time for end of first two year period. Annual renewal presumed.

-> Two new ad hoc committees, Data Advisory and Vascular Composite Allograft. HRSA has made it clear face, hand, and other similar transplants need oversight, and the OPTN is the preferred institution. This makes sense, but is complicated.

-> I.T.: Overhaul proceeds apace. Completion dates in sight for several modules, several independent (mostly web based) parts split off and complete. Rollout over next two years.

-> CEO Search: Final four candidates being interviewed this evening and tomorrow. Decision likely to announced soon.

-> Center performance reports (public flagging (flogging?)): MPSC proposal to change statistical underpinning to Bayesian method. Increased statistical power, but important to calibrate expectations (flagging thresholds).

-> DEQ (Site Evaluations): Iterative feedback on audit practice improving effectiveness and efficiency rapidly.

-> Questions:

  -> Dr. Francis Delmonico (WHO):
  1. Will the OPTN adopt the ISBT 128 for tracking? Still being evaluated.
  2. Will newly required data reports on transplant tourists coming in to the U.S. be public? Should be in annual report. Ethics Committee and International Relations Committee likely to interpret and comment. MPSC continues audit and investigation of violations of 5% limit per center.

KPDPP Report, Ruthanne Leishman:

-> 130 of 231 U.S. living donor transplant center programs now participate in the KPDPP.

-> Match runs every Monday. Most recent brought aggregate total numbers of donor candidates to 825 and would be recipients to 756.

-> To date, of would be recipients entered, 86% have been removed from consideration because they have received a kidney from a living donor.

-> As of September 2013, bridge donors are allowed in the system.

-> Transfer of all operations to UNet functionality expected by end of 2013.

-> Exploring a standard donor acquisition fee billing category with CMS as transportation charges when donor and recipient are in different centers remains a problem for all paired donation programs.

-> Questions:

-> Unknown: Note that many UNOS KPDPP chains collapse as easy-to-match pairs are scooped away by centers and other competing regional and national programs. What about a) exclusive listing, and b) putting all incompatible pairs in the KPDPP, not just the one's that aren't easy-to-match. (Easy-to-match essentially means a recipient who isn't highly sensitized. If the KPDPP is only used as a last straw for the highly sensitized, and others do daily match runs, the easy-to-match will preferentially be pulled out of consideration rapidly, preventing building chains that might better serve the highly sensitized.)

Much more, but not of general interest here on LDO. Interpretation entirely my own, don't blame the presenters for my incorrect summary.