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Region 7 MeetingJulie Heimbach, MDRegional Councillor

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Purpose of Regional Meeting

Discuss regional business

Provide updates on OPTN/UNOS committee activities and projects

Discuss and comment on proposed policies and bylaws

Summary of Spring and Fall 2015 regional meeting Includes sponsoring committee’s response to regional comments Board action on each proposal

Regional Business

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Improving the OPTN Policy Development Process No change post public comment - Approved

Proposal to Establish a Quality Assurance and Performance Improvement Requirement for Transplant Hospitals and Organ Procurement Organizations

Modified proposal to require a QA plan but all details removed – Approved

Definition of a Transplant Hospital Not submitted to the Board

Proposal to Implement Pre-transplant Performance Review by the Membership and Professional Standards Committee

Not submitted to the Board

June Board – Regional Comments

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Proposal for the Definition of Pancreas Graft Failure Modified post public comment to address concerns– Approved

Proposed Changes to the OPTN Bylaws Governing Histocompatibility Laboratories No modifications post public comment - Approved

Policy Rewrite Parking Lot “Quick Fixes” Final proposal did not include HCC modifications – Approved

Proposal to Establish Pediatric Training and Experience Requirements in the Bylaws

Proposal submitted for reconsideration Fall 2015

Proposal to Require Re-Execution of the Match Run when a Deceased Donor’s Infectious Disease Results Impact Potential Recipients based upon Screening Preferences

Modified post public comment to address concerns - Approved

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Spring meeting date: February 18th in Chicago

Spring public comment: January 25-March 25

Check Transplant Pro website for regional meeting date

Spring proposals will be reviewed by the OPTN/UNOS Board in June

Regional Business

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Regional Meeting Attendance Nationaly

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Region 1 Region 2 Region 3 Region 4 Region 5 Region 6 Region 7 Region 8 Region 9 Region 10 Region 11

Fall 2013 100% 77% 62% 65% 87% 100% 85% 88% 89% 85% 69%

Spring 2014 94% 74% 47% 85% 85% 100% 92% 83% 82% 85% 69%

Fall 2014 100% 76% 74% 85% 92% 100% 73% 87% 94% 81% 79%

Spring 2015 88% 74% 57% 83% 90% 100% 85% 87% 94% 88% 69%

Target 75% 75% 75% 75% 75% 75% 75% 75% 75% 75% 75%

40%

50%

60%

70%

80%

90%

100%

Fall 2013 Spring 2014 Fall 2014 Spring 2015 Target

Deadline for regional representative nominations: October 15 Nomination announcement with link to online bio form is posted

on the Transplant Pro website Nominations reviewed by regional nominating committee Regional recommendations considered by OPTN/UNOS

President-Elect Appointments in April for terms beginning July 1

OPTN/UNOS Committee Nominations

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Minority Affairs

OPO

Pancreas

Thoracic

Transplant Administrators

OPTN/UNOS Committee Nominations

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Institutional Participation in Committee Process

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Regional representative to the MPSC for a 2-year term (2016-2018) Councillor position for additional 2 years

Moderate regional meetings Represent the region on the Board of Directors

Election process Call for nominations will be sent on 10/15– deadline October 30 Regional Guidelines – Nominee should be from Illinois If needed the regional nominating committee develops the slate Ballot sent to regional voting representatives

Associate Councillor

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Serves a *2-year term on the Histocompatibility Committee

Call for nominations will be sent on October 15 to labs, deadline is October 30

Election: slate will include the 2 nominees who receive the most nominations, ballot sent to independent lab voting representatives

Histocompatibility Committee Representative

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Regional Data

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Overall waiting list additions increased for third year in a row Slight decrease in both Kidney and Liver additions. Heart additions saw most significant increase.

Total and active registrations at year end peaked again in 2014

Waiting List National Trends

Waiting List Registrations 2005-2014Region 7

Waiting List Registrations 2005-2014Region 7

Waiting List Registrations 2005-2014Region 7

Waiting List Registrations 2005-2014Region 7

Donor and Transplant Data

Deceased donors increased by 4.0% (8,596 from

8,268), and increased donor transplants

decreased by 2.4% from 2013 increases in DCD, SCD donors

DCD donors now comprise 15% of deceased

donors overall (ranges from 7%-32% by region)

2.8% decrease in living donation from 2013-2014.

National Trends

Deceased Donation2013-2014

U.S.

Donors Recovered

Organs Recovered

Organs Transplanted OTPD

2013 8,268 29,403 25,437 3.077

2014 8,596 30,160 26,046 3.03

% Change 4.00% 2.60% 2.40% -1.50%

Donors Recovered

Organs Recovered

Organs Transplanted OTPD

2013 655 2,294 2,005 3.061

2014 684 2,464 2,115 3.092

% Change 4.40% 7.40% 5.50% 1.00%

Deceased Donation2013-2014Region 7

Deceased and Living Donors2005-2014

U.S.

Deceased and Living Donors2005-2014Region 7

Deceased Donors by Type2005-2014

U.S.

7%

Deceased Donors by Type2005-2014Region 7

3%

Percent Change in Deceased Donors and Organs Recovered/Transplanted

2013 – 2014 - Region 7

Region 7Deceased Donors Recovered Deceased Donor Organs Recovered

Deceased Donor Organs Transplanted Deceased Donor OTPD

What should we be looking at??

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UNOS Update

Brian Shepard

UNOS Executive Director

Region 7

OPTN and UNOS Strategic Planning

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2012 v. 2015 Goals

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Feedback from Regional Surveys

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Re-Balancing Resource Allocation

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2015-2016 allocation of effort:Increase transplants 40%Provide equity 30%Improve outcomes 15%Promote safety 10%Promote efficiency 5%

Committee Project Portfolio

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Metrics and quality improvement

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MPSC Outcomes workgroup

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OPO evaluations

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Member Quality Pilot

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Real Life Lessons

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OPTN/UNOS Finance Update

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OPTN Revenue: Registrations

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The OPTN contract is funded with OPTN registration fees and federal appropriations

2016 OPTN budget is $49,497,000.$44,876,000 in OPTN fees for operations

$ 3,500,000 in federal appropriations for operations

$ 1,121,000 to OPTN fees for reserves

2015 OPTN budget was $48,313,000.$43,623,000 in OPTN fees for operations

$ 3,000,000 in federal appropriations for operations

$ 1,690,000 in OPTN fees for reserves

OPTN Funding

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Combined OPTN and UNOS fees remain at $957. OPTN fee increased $19, while UNOS fee declined $19. $20 of each registration fee is dedicated to OPTN reserves. $20 of each registration fee is dedicated to UNOS reserves.

Fees

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Projected Costs and Fees

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FY 2015 FY 2016 FY 2017 FY 2018

Expenditures $46,622,786 $48,376,211 $49,370,410 $50,826,810

Funding

HRSA Federal Appropriations $3,000,000 $3,500,000 $4,000,000 $4,500,000

Reg Funding Carryover from FY 14 (IT fees) 2,100,000 500,000 0 0

Projected Registrations 54,500 56,066 56,727 57,197

Calculated OPTN Base Fee $762 $792 $800 $810

OPTN Base Fee $762 $792 $800 $810

OPTN Reserve Fee $31 $20 $20 $20

Total OPTN Fee $793 $812 $820 $830

UNOS IT update

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2015 IT Releases

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1. Membership Screening for Kidney and Pancreas

2. Revise the Lung Allocation Score (LAS)3. Pediatric Lung Other Specify Diagnosis4. Require HLA C and DQB (First Increment)5. Tiedi OMB Form Changes6. Living Liver Donor Follow-up7. Potential Derived Disease Transmission

Reporting8. Pediatric Liver – Remove ICU

Requirements9. Pediatric Liver – Revise Hepatoblastoma

Requirements10. Update HLA Equivalency Tables

11. Update HLA Equivalency Tables

12. Transnet Android National Deployment

13. Transnet Web OPO Functionality

14. Match Run Changes 15. HOPE ACT membership

application (internal)16. Comprehensive Histo Rewrite17. Deceased Donor Updates18. Transnet iPad (Beta release)19. Infectious Disease20. Transnet TxC Match/Receipt

2015 Board Project Plan

Box Color

Completed

Underway

non-BOD work

Scheduled

Text Color

Projects Approved 2013 or prior

Projects Approved 2014

Scheduled

iPad User Acceptance Testing (UAT) – July 2015 Production release – Q4

Mobile Phones (iPhone6 & 6-Plus, corresponding Android phones) Start Development – August 2015 UAT – Late 2015/early 2016 Production release – Q2 2016

Transplant Center Functionality Completed requirement gathering Start development – June 2015 Beta test (3 centers) – August 2015

Approved projects start prior to next Board meeting

No projects are ever older than 12 months

Board Project Service Level Objective

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Board Approval 50% ofProjects Started

95% ofProjects Started

90% ofProjects Complete

100% ofProjects Complete

Time T=0 T= 3 months T= 6 months T= 9 months T= 12 months

IT Board Backlog by the End of…

2013 20162015201435 Projects7 Delivered5 in progress23 in queue

16 older than 12 months

Regional Business Meeting

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Discussion agenda format is the same as previous meetings

8 public comment proposals Presentation Discussion Regional Vote

Regional Meeting Agenda: Discussion

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Includes 4 proposals anticipated to have a lower impact on the transplant community

Region was offered an opportunity to request that a proposal(s) be placed on the discussion agenda None received

Proposals will be voted on today, but not presented or discussed

Proposals presented and discussed during national webinars

Regional Meeting Agenda: Non-Discussion

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Proposed Changes to Transplant Program Key Personnel Procurement Requirements (Membership and Professional Standards Committee)

Revising Kidney Paired Donation Pilot Program Priority Points (Kidney Transplantation Committee)

Proposal to Update the Human Leukocyte Antigen (HLA) Equivalency Tables (Histocompatibility Committee)

Proposal to Reduce the Documentation Shipped with Organs (Organ Procurement Organization Committee)

Non-Discussion Proposals: VoteYou have the option to abstain from voting if you haven’t reviewed the

proposals

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Public comment booklets on each table

All attendees may discuss and provide feedback

Each OPTN/UNOS member institution has one voting representative

Sponsoring committee considers regional feedback in development of final proposal

Board receives all public comment

Your feedback is important!

Public Comment Proposals

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Contact Regional Representatives http://transplantpro.org/community/regions/

Submit public comment online OPTN website:

http://optn.transplant.hrsa.gov/governance/public-comment/ blog-style format, individual, regional, and committee comments are pubished

Public Comment Opportunities

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The presentations shared today are posted online: http://transplantpro.org/community/regions/ Make sure to review the presentations that weren’t presented today

Additional information available on this website including: Meeting agenda and summaries Data Links to various OPTN resources

Regional Meeting Materials – online!

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Questions?

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