2014 new england organ bank annual...

2014 new eng land or gan bank annua l repor t

d o n a t e l i f e

Dear Friends,

State House – the

Donate Life banner

was displayed at the

MA State House

in April

This is my last annual report letter to the community as I am retiring on March 31, 2015 after assuming the role of NEOB’s CEO in April 1989. At that time, 74 OPOs had just been designated by HCFA (now CMS) as the official US organ recovery agencies. NEOB was a small organization with about 30 employees in a small office on Harvard Street in Brookline Village with an outpost at the Jamaica Plain VA Hospital. The office was staffed Monday to Friday from about 8 to 5. Other times a donation coordinator carried a beeper which literally

just beeped. One then had to find a pay phone and a dime to call the answering service and find out who to call back.

NEOB recovered about 180 organ donors and a handful of tissue donors each year. Donor records were on paper and perhaps a dozen pages long. UNOS’ role as the manager of the OPTN had only recently been established and organ allocation systems were relatively primitive. Most business was conducted over the phone and via a new device called a Fax machine. No cellphones, no text messaging, no e-mail. NEOB had a single Radio Shack computer and we had just made the decision to buy a few Apple Computers, each with less than a MB of memory. There was mini-mal regulation and oversight of OPOs and transplant centers. There were about 20,100 patients on the national waiting list.

25 years later, there are 58 OPOs in a highly regulated environment. An alphabet soup of agencies monitors everything we do. NEOB has about 180 employees and we recovered a record 267 organ donors and 1,930 tissue donors in 2014. The office is staffed 24/7/365, with an additional dozen or so staff on call at all times. Donor records would be several inches thick except they now are electronic. We still use the telephone but more often than not it is a smart phone in our pocket, or a laptop computer with a GB of memory, immense computing power and access to almost anything and anyone in the world in seconds. We still have a Fax machine but rarely use it. Everyone is now instantly available via e-mail, phone or text. We are housed

in a state-of-the-art building with two operating rooms where we recover about 60% of the tissue donors. We have partnered with our transplant centers in helping to make possible the recovery and transplantation of faces and limbs, as well as taking a leading role in the development of kidney paired donation. There are about 123,000 patients on the national waiting list.

I have been privileged to be part of the development of the field of donation and transplantation and to lead NEOB through all these changes. I am proud to have led a superb group of mission-driven staff that has made NEOB’s accomplishments possible. I am particularly pleased that our current Vice President and General Counsel, Alexandra Glazier, will succeed me as President and CEO. Thank you for your support and encouragement for the past 26 years.

Richard S. Luskin President and CEO

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Organ Donation ServicesDuring 2014, New England Organ Bank recovered organs from 267 organ donors with a total of 731 organ transplants. The year represented a record for the number of organ donors in the NEOB Service area as well as a record for organs transplanted.

The donors were from 55 different hospitals throughout the NEOB service area. However, while organ donor referrals from hospitals increased by over 670, the number of referrals that ultimately met the definition of a “poten-tial donor” was only slightly greater than in 2013 (438 vs. 412). This data indicates that NEOB has been successful in working with our hospitals to identify and refer as many donation opportunities as possible - even in in-stances when the chance for donation might be low. Much of the improved referral rates can be attributed to our geographically-based organ donation teams enhancing their relationships in a deeper way with hospital staff at more hospitals.

Data also indicates that the New England region has a challenging dona-tion and transplant environment. For instance, the percentage of our donors considered most likely to donate multiple, high-functioning organs (Stan-dard Criteria Donors) is among the lowest in the country with only 50% of donors falling into that category in 2014. Conversely, 33% of NEOB organ donors were from patients who were Donors after Circulatory Death (DCD), among the highest rate in the country. DCD donors can often donate kidneys and sometimes liver, but seldom other organs such as heart and lung.

We also continue to see a change in other aspects of our donor population with an increase in patients testing positive for Hepatitis C virus. The combination of a relatively low percentage of standard criteria donors, a high percentage of DCD donors and the growing number of increased risk donors, makes organ placement a continuing challenge.

In 2014, NEOB saw an increase in organs placed for research which is an improvement goal set by the federal government for all organ procure-ment organizations. The average number of research organs per donor was .63 last year, up from .50 for 2013. NEOB has made a concerted effort to increase the supply of research organs to approved local programs as part of our continuing historical mission to be at the forefront of improvements in the field of transplantation.

NEOB continues to maintain a high conversion rate of eligible donors as measured by the federal government at 82.2% (above the national mean) for 2014. Organ Donation Services staff has focused efforts to improve our response on site times at donor hospitals and to decrease the instances when hospital staff mention donation to families before NEOB arrives. We believe that improving these two measures will have a positive impact on the organ donation conversion rate and more lives will be saved.

Scott Dyson – heart , liver and kidney donor

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Last year, donated tissue was used in over one million surgical procedures nationwide. It has become a critical part of enhancing the lives of many pa-tients suffering the infirmities of ill health and disease. NEOB is a national leader in meeting this growing need. Last fiscal year, our number of tissue donors increased by 10% as more families and registered donors said “yes” to tissue donation and as donor criteria expanded to meet the demand for transplantable tissue from the medical community.

An increased demand for musculoskeletal (MS) tissue - such as bone and tendon - resulted in a 21% increase in this type of tissue compared to the prior year. Several factors have contributed to the expansion of tissue donor criteria to donors of advanced age, including an increased tissue use in dental procedures, spine surgeries and the growing use of a bone-derived putty in a variety of surgical procedures. The continued use of donated skin for post-mastectomy breast reconstruction and its growing use in other surgeries resulted in a 13% growth in skin donation. All other tissue types increased at least 10%.

Tissue Donation ServicesIt is a testament to the work of NEOB and the entire donation community that the expansion of tissue donation over the past decade has led to a suf-ficient supply of many tissues that are most commonly used in the United States today. NEOB’s tissue services team must remain flexible as changes in the national healthcare system continue to influence the demand for these grafts.

NEOB aspires to afford all families of potential tissue donors the oppor-tunity to donate. Working with our hospital partners, we improved the “timely referral” rate from 75% to 79%. A timely referral is any hospital referral of a potential tissue donor that occurs within one hour of death. The one hour time frame allows NEOB to begin an authorization and donation process within the time window required by the FDA. Data shows that referrals outside the one hour time requirement are much more likely to result in delays that can lead to no donation taking place. As such, the overall NEOB Tissue Conversion rate has increased steadily in the past de-cade from 14% to 26%. This is the rate of medically suitable potential tis-sue donors from whom at least one tissue was recovered. The improvement is the result of changes in process, improved staff and hospital training and the public’s increased participation in donor registries.

NEOB’s Tissue Recovery Center (TRC) located at our headquarters completed its third year of operation and NEOB opened a second cen-ter in Portland Maine. During 2014, 59% of NEOB’s tissue donors were transported from the hospital setting to one of these centers, allowing us to more consistently meet the expectations of funeral directors and allowing our tissue recovery staff to spend significantly less time traveling and more time performing the actual recovery procedures. Most importantly, the use of the TRC allows us to provide more and better information to donor families as they make funeral decisions for their loved one.

Henry Monroe became a skin donor at 80

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We also had many repeat programs continuing and building upon past successes: Londonderry Old Homes Day Parade in NH and the Falmouth, MA Road Race where 20 runners representing NEOB raised over $40,000 for donation awareness and educational program in our region.

We continue to communicate with our supporters on a daily basis through social media. Our Facebook, Twitter and new Instagram accounts allow us to share news stories, upcoming events and photos of our volunteers through out the year. Our social media activity allows us to connect with a one of the largest Donate Life audiences in the nation to encourage them to share their dedication to donation within their personal social networks.

An important element of New England Organ Bank’s mission to save and enhance lives through organ and tissue donation is increasing the number of those in our region who designate themselves as registered donors. We have sought to make our committed volunteers the core of these commu-nity outreach efforts and to expand our ability to speak in a meaningful way to a larger and more diverse audience.

With over 500 volunteers representing all six New England states, our team works throughout the year to educate their local communities about donation and encourage friends, family and neighbors to join the registry. Their willingness to share personal - and sometimes difficult - stories helps demonstrate the dramatic impact that one person can make by register-ing as a donor. In 2014, our volunteers visited health fairs, motor vehicle offices, schools, parades, sporting events, festivals and many more locations and events to promote donation.

In July, NEOB sponsored fourteen athletes from New England to attend the 2014 Donate Life Transplant Games in Houston, Texas. The event made a great impact on attendees, their family and friends all of whom were inspired by transplant recipients, living donors and donor families coming together to celebrate life, honor their donors and share their experiences with participants from all over the country. Team New England came home with 25 medals and a lifetime of wonderful memories.

This year, NEOB had the opportunity to partner with jewelry retailer Alex and Ani on a national Donate Life promotion. Stores in Portsmouth, NH and Portland, ME hosted Donate Life nights with a portion of sales that day donated to New England Organ Bank. The events gave us the oppor-tunity to connect with shoppers and talk to them about donation. Other first-time programs we offered this year included a Donor Sabbath gospel sing at the First Church of Christ in New Haven, CT, involvement at the large DeafNation Expo in Boston and sponsorship of the Donate Life float at the Stamford, CT Parade Spectacular.

Community Awareness

Recipients, living donors, donor family members, NEOB staff and supporters traveled to Houston, TX in July for the 2014 Donate Life Transplant Games.

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State InitiativesA signature goal of New England Organ Bank’s daily efforts is to both educate the public about organ and tissue donation and to increase the number of registered donors. This effort has proven successful as there are now over 6 million individuals registered as donors in New England, the highest level to date. This increase in registration is mostly the result of the strong partnerships we have cultivated with key constituents throughout our service area.

Each state plays an important role in the organ and tissue donation process as 99% of all individuals who register as donors do so at their state Department of Motor Vehicles. Because of this critical DMV role, we focus great attention to moving individuals to make the decision to have the heart put on their driver’s license. In videos that are played on flat-panel TVs in MA, RI, and NH DMV branch offices, we have highlighted on the pride of registering as a donor and seeing that heart on one’s own license. Similarly, in Vermont we are preparing to launch the “Do You Have a Heart?” campaign – leveraging that universal symbol of the gift of donation and encouraging people to claim it for their own when getting their license.

The success of our efforts is readily evident through both monthly and annual data collection. As an example, our work over several years in Mas-sachusetts has proven to yield success in overall registered donors for both men and woman. In 2009, Massachusetts had a registration rate of 35%, with woman registering at a 39% level and men 31%. In 2014 that percent-age had increased to 45% overall and the women rate increased to 49% and men increased to 41%. Measurable results such as this demonstrates the success of these outreach efforts and our ability to track improvement.

New England Organ Bank now participates in Organ and Tissue Donation Advisory Councils of some kind in all six states. These legislatively created groups provide an opportunity to bring important stakeholders together

to focus on public education, awareness and registration campaigns, and to review data. The council’s ordinarily consist of the state’s Department of Public Health, doctors from transplant centers, DMV leaders, legislators, individuals personally touch by donation and the local federally designated Organ Procurement Organizations, to focus on the specific needs of that state. NEOB also helped to pass legislation in Massachusetts and Maine creating an opportunity for individuals to donate $2 or more when renew-ing a driver’s license to an organ and tissue donation education fund. These funds are specifically earmark for education and public outreach. The support and interest of the public for this fund is readily evident in just a few years as drivers in Massachusetts have now contributed over $500,000. Similarly, in Maine, the fund has proven to be a success garnering signifi-cant donations each month at the Bureau of Motor Vehicles. Our goal is to develop such funds in all New England states.

NEOB volunteers and staff

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New England Organ Bank Board of

Trustees as of December 31, 2014

Greger AndersonPat BaillieulRoberta (Bobbi) ClarkeGreg Couper, MD (Chair)Hon. Geoffrey Crawford (Vice Chair)Richard B. Freeman, MDAlexandra Glazier, Esq. (Assistant Secretary) Jane Holtz Cale Keable, Esq.Heung Bae Kim, MDThomas “Tucker” Leary (Assistant Treasurer)Richard S. Luskin (Secretary) Ex-officioEugene Wallace (Treasurer)

New England Organ Bank Clinical Policy

Board as of December 31, 2014

David Axelrod, MDMichael Bauer, MDAdel Bozorgzadeh, MDJohn Butterly, MD Phillip Camp, MDBob Canfield Francis L. Delmonico, MD (Chair) Ex-officioKevin M. Dushay, MDDavid Fisher, MD

Francis Fynn-Thompson, MDGalen Henderson, MDW. David Lewis, MDJim Markmann, MDEdgar L. Milford, MDPaul Morrissey, MD Kari MullDavid Mulligan, MDMatthew Nuhn, MDRick Rohrer, MDEllen SheehyWilliam Tomford, MDDavid TrullStefan Tullius, MDJames Whiting, MD

Medical Director

Francis L. Delmonico, MD Associate Medical Directors

Michael Bauer, MDPhillip Camp, MDKevin M. Dushay, MDGalen Henderson, MDW. David Lewis, MDWilliam Tomford, MD

Andrew Campbell – organ donor from Maine Recipient family – heart recipient Brad Biscornet with wife Mandra and son Darby.

Alex and Ani – NEOB staff and volunteers attended Donate Life night at Alex and Ani in Portland, Maine

Carrie Little – double lung transplant recipient

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Donors by HospitalState Hospital Tissue Donors Organ Donors

BE King Edward VII Memorial Hospital 0 1

CT Bridgeport Hospital 29 2

CT Danbury Hospital 34 3

CT Greenwich Hospital 4 0

CT Griffin Hospital 4 1

CT Milford Hospital 8 0

CT New Milford Hospital 6 0

CT Norwalk Hospital 16 5

CT St. Mary's Hospital 12 1

CT St. Vincent's Medical Center 27 5

CT Stamford Hospital 11 4

CT VA Connecticut HealthCare System - West Haven

1 0

CT Waterbury Hospital 15 2

CT Yale New Haven Hospital 50 18

CT Yale New Haven Hospital - St. Raphael Campus

6 0

MA Addison Gilbert Hospital 8 0

MA Anna Jaques Hospital 12 0

MA Athol Hospital 5 0

MA Baystate Wing Hospital 4 0

MA Berkshire Medical Center 32 2

MA Beth Israel Deaconess Medical Center 34 16

MA Beth Israel Deaconess Hospital-Needham 3 0

MA Beth Israel Deaconess Hospital-Plymouth 21 0

MA Beverly Hospital 17 0

MA Boston Children's Hospital 10 6

MA Boston Medical Center 18 11

MA Brigham & Women's Hospital 44 10

State Hospital Tissue Donors Organ Donors

MA Cambridge Health Alliance Cambridge Hospital

5 0

MA Cambridge Health Alliance Whidden Hospital

12 1

MA Cape Cod Hospital 44 3

MA Caritas Carney Hospital 6 0

MA Clinton Hospital 8 0

MA Cooley Dickinson Hospital 10 2

MA Emerson Hospital 13 0

MA Falmouth Hospital 14 0

MA Faulkner Hospital 4 1

MA Good Samaritan Medical Center 19 0

MA Harrington Hospital Southbridge Campus

17 0

MA Harrington Hospital - Webster Campus 5 0

MA Health Alliance Hospital Leominster Campus

18 0

MA Hebrew Rehabilitation Center 1 0

MA Heywood Hospital 5 0

MA Holy Family Hospital 11 0

MA Holy Family Hospital at Merrimack 15 0

MA Holyoke Medical Center 4 2

MA Kindred Hospital - Boston 1 0

MA Kindred Hospital Boston North Shore 1 0

MA Lahey Hospital And Medical Center 29 4

MA Lahey Medical Center North Shore 1 0

MA Lawrence General Hospital 19 2

MA Lawrence Memorial Hospital Of Medford 3 0

MA Lowell General Hospital - Main Campus 30 3

January 1, 2014 – December 31, 2014

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MA Lowell General Hospital - Saints Campus 8 1

MA Marlborough Hospital 7 0

MA Masconomet Healthcare 1 0

MA Massachusetts General Hospital 69 27

MA Melrose-Wakefield Hospital 8 0

MA Metrowest Medical Center 16 3

MA Metrowest Medical Center Leonard Morse

3 0

MA Milford Regional Medical Center 23 0

MA Milton Medical Center 2 0

MA Morton Hospital 15 1

MA Mount Auburn Hospital 10 2

MA Nashoba Valley Medical Center 5 0

MA New England Sinai Hospital 1 0

MA Newton-Wellesley Hospital 11 0

MA North Adams Regional Hospital 5 0

MA North Shore Med Ctr Lynn Union Campus

9 0

MA North Shore Medical Ctr -Salem Campus 9 0

MA Norwood Hospital 28 1

MA Quincy Medical Center 8 1

MA Saint Anne's Hospital 10 1

MA Saint Vincent Hospital 29 2

MA Signature Healthcare Brockton Hospital 28 4

MA South Shore Hospital 38 8

MA Southcoast Hospital-Charlton Memorial 27 1

MA Southcoast Hospital - St. Luke's Hospital 27 5

MA Southcoast Hospital - Tobey Hospital 8 0

MA Spaulding Hospital - Cambridge 1 0


MA St. Elizabeth's Medical Center 10 0

MA Sturdy Memorial Hospital 30 0

MA Tufts Medical Center 16 6

MA UMMHC - Memorial Campus 6 3

MA UMMHC - University Campus 57 23

MA VA Boston HealthCare System - West Roxbury Campus

2 0

MA Whittier Rehabilitation Hospital - West-borough

1 0

MA Winchester Hospital 16 0

ME Blue Hill Memorial Hospital 2 0

ME Bridgton Hospital 3 0

ME Central Maine Medical Center 25 7

ME Down East Community Hospital 3 0

ME Eastern Maine Medical Center 52 9

ME Franklin Memorial Hospital 1 0

ME Houlton Regional Hospital 2 0

ME Inland Hospital 3 0

ME Lincoln Health 2 0

ME Maine Coast Memoral Hospital 1 0

ME Maine General Health - Augusta Cam-pus

13 0

ME Maine General Health - Thayer Campus 1 0

ME Maine Medical Center 58 18

ME Mayo Regional Hospital 2 0

ME Mercy Hospital 4 0

ME Mid Coast Hospital 13 0

ME Mount Desert Island Hospital 1 0

ME Parkview Adventist Medical Center 1 0

Donors by Hospital

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ME Penobscot Bay Medical Center 3 0

ME Redington Fairview General Hospital 3 0

ME Rumford Hospital 2 0

ME Sebasticook Valley Hospital 3 0

ME Southern Maine Health Care - Sanford 6 0

ME Southern Maine Health Care - Biddeford 6 0

ME St. Joseph Hospital 4 0

ME St. Marys Regional Medical Center 3 0

ME Stephens Memorial Hospital 1 0

ME The Aroostook Medical Center 2 0

ME Waldo County General Hospital 2 0

ME York Hospital 3 0

NH Androscoggin Valley Hospital 3 0

NH Catholic Medical Center 30 1

NH Cheshire Medical Center 10 0

NH Concord Hospital 29 2

NH Cottage Hospital 1 0

NH Dartmouth Hitchcock Medical Center 34 6

NH Elliot Hospital 13 1

NH Exeter Hospital 18 0

NH Franklin Regional Hospital 3 0

NH Frisbie Memorial Hospital 12 1

NH Huggins Hospital 4 0

NH Lakes Region General Hospital 9 0

NH Littleton Regional Healthcare 2 0

NH Memorial Hospital 4 0

NH Monadnock Community Hospital 5 0

NH New London Hospital 4 0

NH Parkland Medical Center 10 1


NH Portsmouth Regional Hospital 11 0

NHSouthern New Hampshire Regional Medical Center

17 2

NH Speare Memorial Hospital 1 0

NH St. Joseph Hospital 11 0

NH Valley Regional Hospital 4 0

NH Weeks Medical Center 3 0

NH Wentworth-Douglass Hospital 12 1

RI Kent Hospital 19 0

RI Landmark Medical Center 17 1

RI Memorial Hospital Of Rhode Island 7 1

RI Miriam Hospital 7 0

RI Newport Hospital 7 1

RI Providence VA Medical Center 1 0

RI Rhode Island Hospital 65 20

RI Roger Williams Medical Center 2 1

RI South County Hospital 9 0

RI St. Joseph's Health Services 3 0

RI Westerly Hospital 4 0

RI Women and Infants Hospital 2 0

VT Brattleboro Memorial Hospital 3 0

VT Central Vermont Medical Center 6 0

VT Gifford Medical Center 1 0

VT Mt. Ascutney Hospital & Health Center 2 0

VT North Country Hospital 6 0

VT Springfield Hospital 2 0

VT White River Junction VA Medical Center 1 0

VT Northeastern VT Regional Hospital 1 0

VT Springfield Hospital 7 0

Donors by Hospital

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Total Gift Statistics

Standard Criteria Donors (SCD) -Donors who do not meet any of the criteria for an ECD and from whom donation occurred after brain death.

Extended Criteria Donors (ECD) - Donors who, at the time of death, is aged ≥60, or aged 50 to 59 and has any two of the following three criteria: (1) Cause of death is cerebrovascular accident; (2) preexisting history of systemic hypertension; and (3) terminal serum creatinine >1.5 mg/dl.

Donation after Circulatory Death (DCD) - Donation after Circulatory Death (DCD) - Donors who do not meet the criteria for brain death but in whom irreversible cessation of circulatory and respiratory functions occurred before the organs were procured.

The Health Services and Resources Administration uses a standardized “Conversion Rate” to measure the performance of organ recovery agencies across the nation. The rate measures the ability of OPOs to maximize organ recovery and transplants based on potential organ donors, including donors after circulatory death and donors after brain death. NEOB’s conversion rate for 2014 was 82.2%, above the national goal of 75%.

SCD ECD DCD TOTAL

2011 125 52 52 229

2012 109 41 67 217

2013 125 45 78 248

2014 133 47 87 267

Organ Donors

0

20

40

60

80

100Conversion Rate

2014201320122011

80.1% 77.9% 77.7% 82.2%1000

1500

2000

1000

1500

2000Tissue Donors

2014201320122011

Tissue Donors

1342

15971652

1930


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The total number of organ and tissue donors in 2014 was 2092, an increase from the previous year. The increase was achieved through a steady improvement in the tissue consent rate over time and an increase in the demand for some types of tissue.

2014- 731 total organs

2013-676 total organs

2013Small bowel.............1Pancreas .................22Lung....................... 29*Liver..................154**Heart ....................... 67Kidney................... 378

Total Donors ...248


Total Donors .. 267

Number of organs transplanted

0 100 200 300 400 500 600 700 800

0

500

1000

1500

2000

2500

Organ OnlyOrgan & TissueTissue Only

2014 - 20922013 -1781

135 105

162

1825

113

1652

Number of Donors

Total Gift StatisticsJanuary 1, 2014 – December 31, 2014

2014- 731 total organs

2013-676 total organs


Total Donors ...248


Total Donors .. 267

Number of organs transplanted

0 100 200 300 400 500 600 700 800

0

500

1000

1500

2000

2500

Organ OnlyOrgan & TissueTissue Only

2014 - 20922013 -1781

135 105

162

1825

113

1652

Number of Donors

*Double lungs counted as one transplant** Split livers counted as two transplants

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Total Gift Statistics

2013Tendon.........................................736Pericardium ................................. 59Skin..............................................1243Femoral vein............................... 69Cornea......................................1011Aortoiliac artery...................... 70Saphenous vein .......................203Heart valve................................267Bone ..............................................926Descending Thoracic Aorta...24

2014Tendon.........................................777Pericardium ................................. 90Skin..............................................1410Femoral vein............................... 62Cornea......................................1134Aortoiliac artery...................... 49Saphenous vein .......................162Heart valve................................237Bone ..............................................930Descending Thoracic Aorta...23

0 1000 2000 3000 4000 5000

Number of Tissue donors by Type of Tissue

(donors may donate more than one type of tissue)


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New England Organ Bank Affiliated Transplant CentersBeth Israel Deaconess Medical CenterBoston Children’s HospitalBoston Medical CenterBrigham and Women’s HospitalDartmouth-Hitchcock Medical CenterLahey Hospital and Medical CenterMaine Medical CenterMassachusetts General HospitalRhode Island HospitalTufts Medical CenterUMass Memorial Medical CenterYale-New Haven Hospital

www.neob.orgwww.DonateLifeNewEngland.org

2014 new england organ bank annual...

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