Access information from the OPTN/UNOS November 2013 board meeting

[Clark]

http://transplantpro.org/access-information-from-the-november-2013-board-meeting/

Access information from the November 2013 board meeting

The OPTN/UNOS board of directors held its semi-annual meeting in Atlanta, Georgia, November 11-12, 2013. Read about actions taken and view public presentations from the meeting.

Executive Summary http://optn.transplant.hrsa.gov/SharedContentDocuments/ExecutiveSummary_1113.pdf

EXECUTIVE SUMMARY
OF THE MINUTES
OPTN/UNOS BOARD OF DIRECTORS MEETING
November 11-12, 2013
Atlanta, GA
Kenneth Andreoni, M.D., OPTN/UNOS President called the meeting to order at 2:35 p.m. on
November 11, 2013. A quorum was present, and 40 of the Board members were in attendance
during the meeting.
The Board approved several resolutions contained in the Consent Agenda in a single vote. One
item was removed from the consent agenda for further discussion during the meeting. The
subject of the individual resolutions approved in the Consent Agenda follows here:
1. The Board approved the minutes of the June 24-25, 2013, meeting of the Board of
Directors held in Richmond, Virginia.
2. The Board approved modifications to Appendix 3A (HLA Antigen Values and Split
Equivalences) to update the tables to reflect OPTN/UNOS Policy Appendix 3D, Section
D.2 (Histocompatibility Laboratory Testing Requirements), which requires laboratories to
perform molecular typing for deceased kidney, kidney-pancreas, and pancreas donors.
The Board also rescinded its prior approval of a 2010 change that would disadvantage
certain sensitized candidates, and approved a new “user friendly” format for the tables.
3. The Board approved the following member-specific actions for new members: fully
approved two new transplant programs in one new transplant hospital member, and
three new individual members; for existing members: the Board fully approved five new
transplant programs; fully approved three medical/professional organizations, one public
organization, one business, and one individual member for another two-year term. The
Board approved the following changes in program status: granted full approval to three
programs and one living donor component that reactivated in three existing transplant
hospitals, and granted full approval to one existing transplant program and one existing
living donor component that were conditionally approved; and granted a 12-month
extension of conditional approval status to one existing living donor liver component that
is conditionally approved.
4. The Board extended the effective date from December 1, 2013, to January 1, 2015, for
modifications to Policies 7.1.6 (Eligible Death Definition) and 7.1.7 (Imminent
Neurological Death), which were approved by the Board of Directors on June 24, 2013.
This later effective date will permit CMS additional time to align its definitions with the
OPTN definitions, and also provide additional time for member education and computer
programming.
Following passage of the Consent Agenda, the Board approved substantial changes to the
Bylaws Article 1.4 (Histocompatibility Laboratory Member); Appendix C.1 (Histocompatibility
Laboratory Compliance), Appendix C.2 (Facilities and Resources), Appendix C.3
(Histocompatibility Laboratory Personnel), Appendix C.4 (Changes in Key Laboratory Executive Summary Page 2
November 11-12, 2013, Board of Directors Meeting
Personnel), Appendix M: (Definitions), and the creation of section C.4 (Laboratory Coverage
Plan). These changes will better reflect current clinical practice and set standards to ensure that
histocompatibility laboratories have adequate staff coverage to provide high quality testing for
transplant programs and OPOs. The Board understands the need to develop a process to
approve and timely respond to changes in histocompatibility laboratory requirements that may
be updated by ASHI and CAP.
The Board approved changes to Policy 3.1.14 (PHS Guideline) to eliminate the option to use
the 1994 Public Health Service Guidelines for medical-evaluation of both potential deceased
and living donors, effective February 1, 2014.
The Board approved modifications to Policy 2.8 (Model Elements for Controlled DCD), to reflect
changes to the DCD (now known as Donation after Circulatory Death) model elements, and
included additional language clarifying the definition of patients who may appropriately become
eligible to become DCD donors.

 ***
The Board discussed a framework for how committees should address geographic disparities in
organ distribution, but took no formal action.
 ***

The Board received and discussed an extensive presentation on the OPTN Kidney Paired
Donation (KPD) Program.
Based upon its assessment of the significant programming costs compared to the relatively
small number of affected candidates, the Board declined to approve proposed changes to Policy
3.6.4.1 (Adult Candidate Status) that would have added serum sodium to the calculation of the
Model for End-Stage Liver Disease (MELD) score. On the second day of the meeting, there
was a motion to reconsider the proposal, which the Board declined to approve.
In the first order of business of the second day of the meeting, the Board approved changes to
the Bylaws Articles 6.2 (Vice President) and 7.2 (Standing Committee Chairs) that separate the
roles of the Vice-President of the Board of Directors and the Chair of the Membership and
Professional Standards Committee (MPSC). The Bylaws formerly required the Vice-President to
serve as the Chair of the MPSC. The Board acknowledged the need to develop criteria and
preferred qualifications for committee leadership positions.

 ***
The Board approved changes to Policy 12.4.1 (IDA Role) and Policy 12.4.2 (IDA
Responsibilities), and new Policy 12.4.3 (IDA Protocols), which clarify requirements for
Independent Donor Advocates at living donor recovery centers.
 ***

The Board directed the Liver and Intestinal Organ Transplantation Committee to develop a
conceptual plan and timeline for the implementation of a national liver review board, for
presentation to the Board of Directors in June 2014.
The Board approved a plain language rewrite of all OPTN/UNOS policies, which have been
rewritten for clarity and consistency. The rewritten policies do not contain substantive changes.
The meeting adjourned at 12:50 p.m. on November 12, 2013.


News Release
Presentations
Ad Hoc Disease Transmission Advisory Committee Action Items
Ad Hoc Disease Transmission Advisory Committee Report
Executive Committee Report
Histocompatibility Committee Action – Bylaws
Histocompatibility Committee Action – HLA
Kidney Committee Report http://transplantpro.org/wp-content/uploads/Board_11-2013_Kidney_Committee_Report.pdf
Kidney Paired Donation Update http://transplantpro.org/wp-content/uploads/Board_11-2013_KPD_Update.pdf
Liver and Intestinal Organ Committee Action Items

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Living Donor Committee Action Items http://transplantpro.org/wp-content/uploads/Board_11-2013_Living_Donor_Committee_Action.pdf
Living Donor Committee Report http://transplantpro.org/wp-content/uploads/Board_11-2013_Living_Donor_Committee_Report.pdf
 ***

Membership & Professional Standards Committee Report
Operations and Safety Committee Report
OPO Committee Actions
OPO Committee Report
OPTN Finance Committee Report

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Policy Oversight Committee Actions http://transplantpro.org/wp-content/uploads/Board_11-2013_Policy_Oversight_Committee_Actions.pdf
 ***

Policy Oversight Committee Action – Rewrite
UNOS IT Advisory Committee Report
UNOS IT Update

[Clark]

I included the Executive Summary, as this must have been quite a meeting. I highlighted items of particular interest to living donors in the Executive Summary as well as highlighting and providing links to the committee reports and slides of import. The POC discussion of how to effectively proceed in addressing geographic disparity is excellent and very encouraging that significant progress may be in the offing sooner than many expect. May it be so.