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Upcoming heart allocation policy change

If you are a patient on the national waiting list for a heart, your urgency for a transplant is currently based on three statuses:

  • 1A (most urgent)
  • 1B (somewhat urgent)
  • 2 (least urgent)

As we learn more about heart disease and successful treatment of it, the transplant community determined we needed more specific criteria that reflects a heart patient’s current health and care they are getting. To accommodate these needs, we are making changes to heart policy and the first phase of the new heart allocation policy will take effect on September 18.

Heart candidates can find specific information here about how this change will affect you. You can also download a print version from the website.

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OPTN/UNOS Board adopts principles of geographic organ distribution

Richmond, Va. – The OPTN/UNOS Board of Directors, at its meeting June 11-12, adopted a set of principles to guide future organ transplant policy relating to geographic aspects of organ distribution. The Board approved the principles by a vote of 32 in favor and five opposed.

“Geography presents inherent challenges in developing equitable transplant policy for candidates across the nation,” said Yolanda Becker, M.D., president of the OPTN/UNOS Board of Directors. “There are differences in the distribution of transplant centers and in the size and configuration of organ procurement organizations. In addition, there is geographic variability in the concentration of disease patterns that cause organ failure and causes of death that make organ donation possible. Adopting these principles is a necessary first step to address issues of geography in a systematic way.”

The statement of principles reads as follows:

Deceased donor organs are a national resource to be distributed as broadly as feasible. Any geographic constraints pertaining to the principles of organ distribution must be rationally determined and consistently applied.

 

Geographic distribution may be constrained in order to:

  1. Reduce inherent differences in the ratio of donor supply and demand across the country
  2. Reduce travel time expected to have a clinically significant effect on ischemic time and organ quality
  3. Increase organ utilization and prevent organ wastage
  4. Increase efficiencies of donation and transplant system resources

These principles were recommended by the Ad Hoc Geography Committee, which the Board formed in December 2017 to study the issue and make recommendations. The committee will seek public feedback beginning in August on three potential frameworks it has recommended (fixed distance from donor hospital, mathematical optimized distribution areas and borderless distribution), consistent with the principles, that may be used as a basis for future organ distribution policy. Also, at the committee’s recommendation, the Board called for an analysis of current organ distribution policies in reference to the approved principles. The OPTN/UNOS Executive and Policy Oversight Committees may use this analysis to prioritize the future work of relevant committees.

“Among various issues relating to the impacts of organ allocation policies, the Board had a robust discussion of potential effects on vulnerable populations as addressed in federal law and regulation,” added Dr. Becker. “These do not conflict with the geographic distribution principles as approved, and the OPTN will also assess these issues on an ongoing basis.”

The Board also voted to retain the lung distribution policy adopted on an emergent basis in November 2017 by the OPTN/UNOS Executive Committee, while adding a policy option to provide exception priority for highly sensitized lung candidates. The policy removed the local donor service area as the first level of lung distribution, instead establishing the first level as transplant centers located within 250 nautical miles of the donor hospital. This policy will continue to be examined in light of the newly adopted principles of geography.

In other key actions:

  • The Board adopted revisions to OPTN bylaws that outline the process for review of member organizations for compliance with OPTN requirements and for addressing potential issues of quality or patient safety. The revisions clarify the review process and resolve some potentially conflicting details in the prior bylaws.
  • The Board also approved revisions to OPTN requirements for informed consent regarding diseases that may be transmitted from donor to the potential recipient; the updates reduce ambiguity in the medical conditions and test results to be addressed and the processes involved in communication.

The Organ Procurement and Transplantation Network (OPTN) brings together medical professionals, transplant recipients and donor families to develop national organ transplantation policy. United Network for Organ Sharing serves as the OPTN under contract with the Department of Health and Human Services, Health Resources and Services Administration.

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OPTN/UNOS Board adopts principles of geographic organ distribution

Richmond, Va. – The OPTN/UNOS Board of Directors, at its meeting June 11-12, adopted a set of principles to guide future organ transplant policy relating to geographic aspects of organ distribution. The Board approved the principles by a vote of 32 in favor and five opposed.

“Geography presents inherent challenges in developing equitable transplant policy for candidates across the nation,” said Yolanda Becker, M.D., president of the OPTN/UNOS Board of Directors. “There are differences in the distribution of transplant centers and in the size and configuration of organ procurement organizations. In addition, there is geographic variability in the concentration of disease patterns that cause organ failure and causes of death that make organ donation possible. Adopting these principles is a necessary first step to address issues of geography in a systematic way.”

The statement of principles reads as follows:

Deceased donor organs are a national resource to be distributed as broadly as feasible. Any geographic constraints pertaining to the principles of organ distribution must be rationally determined and consistently applied.

 

Geographic distribution may be constrained in order to:

  1. Reduce inherent differences in the ratio of donor supply and demand across the country
  2. Reduce travel time expected to have a clinically significant effect on ischemic time and organ quality
  3. Increase organ utilization and prevent organ wastage
  4. Increase efficiencies of donation and transplant system resources

These principles were recommended by the Ad Hoc Geography Committee, which the Board formed in December 2017 to study the issue and make recommendations. The committee will seek public feedback beginning in August on three potential frameworks it has recommended (fixed distance from donor hospital, mathematical optimized distribution areas and borderless distribution), consistent with the principles, that may be used as a basis for future organ distribution policy. Also, at the committee’s recommendation, the Board called for an analysis of current organ distribution policies in reference to the approved principles. The OPTN/UNOS Executive and Policy Oversight Committees may use this analysis to prioritize the future work of relevant committees.

“Among various issues relating to the impacts of organ allocation policies, the Board had a robust discussion of potential effects on vulnerable populations as addressed in federal law and regulation,” added Dr. Becker. “These do not conflict with the geographic distribution principles as approved, and the OPTN will also assess these issues on an ongoing basis.”

The Board also voted to retain the lung distribution policy adopted on an emergent basis in November 2017 by the OPTN/UNOS Executive Committee, while adding a policy option to provide exception priority for highly sensitized lung candidates. The policy removed the local donor service area as the first level of lung distribution, instead establishing the first level as transplant centers located within 250 nautical miles of the donor hospital. This policy will continue to be examined in light of the newly adopted principles of geography.

In other key actions:

  • The Board adopted revisions to OPTN bylaws that outline the process for review of member organizations for compliance with OPTN requirements and for addressing potential issues of quality or patient safety. The revisions clarify the review process and resolve some potentially conflicting details in the prior bylaws.
  • The Board also approved revisions to OPTN requirements for informed consent regarding diseases that may be transmitted from donor to the potential recipient; the updates reduce ambiguity in the medical conditions and test results to be addressed and the processes involved in communication.

The Organ Procurement and Transplantation Network (OPTN) brings together medical professionals, transplant recipients and donor families to develop national organ transplantation policy. United Network for Organ Sharing serves as the OPTN under contract with the Department of Health and Human Services, Health Resources and Services Administration.

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UNOS announces 2018 National Donor Memorial Award winner

United Network for Organ Sharing (UNOS) named Terry Murray of Olney, Md., the winner of its 2018 National Donor Memorial Award for Excellence in recognition of her untiring efforts as a donation advocate.

Terry has long understood the importance of organ donation and transplantation. Her mother donated a kidney to her brother in 1977. Twenty-two years later Terry’s husband, Alan, died from a tragic fall and became a tissue donor. Donation helped Terry and her children cope with their loss. When Terry retired from teaching school in 2003, she felt compelled to educate high school students about what it means to be a donor. Every year Terry presents to all 26 Montgomery County, MD., high schools. In the past 15 years, she has volunteered almost 1,000 hours to promote donation.

“Educating young people about the importance of organ, eye and tissue donation is essential to increasing the number of lives saved through organ transplantation,” said UNOS President Yolanda Becker, M.D. “Terry’s continued work with Maryland high school students has directly increased donor registrations in the state.”

UNOS established the National Donor Memorial Award for Excellence in 2010 to recognize exceptional advocates who promote organ donation and transplantation. UNOS solicits nominations for the award from the organ procurement organizations and transplant centers in the United States. Terry was nominated by Washington Regional Transplant Community. Previous winners have been donor family members, a social worker/donation advocate, a liver recipient, and the sister of a heart recipient.

UNOS, a private, nonprofit organization, unites and supports the organ donation and transplantation community nationwide through organ placement, research, technology, policy development and education. UNOS serves as the nation’s Organ Procurement and Transplantation Network (OPTN) under federal contract. As the OPTN, it matches lifesaving organs with people awaiting transplants nationwide and manages the national database of medical information about transplant candidates, recipients, and donors.

Headquartered in Richmond, Va., UNOS is also home to the National Donor Memorial, which honors the life-giving impact of organ and tissue donation.

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New booklet advises parents of pediatric transplant patients

A new resource booklet, “What Every Parent Needs to Know,” is available for parents and caregivers of children and adolescents who need or receive an organ transplant. The OPTN/UNOS Patient Affairs Committee spearheaded the booklet’s development in collaboration with a number of transplant professionals and parents of organ transplant recipients*.

The booklet explains the transplant process from a parent’s viewpoint. It addresses issues before and during a transplant such as financial concerns and explaining deceased donation to a child, as well as guidance on helping children manage life after a transplant. It addresses a number of concepts and terms relating to transplantation and provides references to other helpful resources.

* The Patient Affairs Committee also wishes to thank the following organizations for reviewing the booklet:

  • American Liver Foundation
  • American Society of Transplantation
  • Anne & Robert H. Lurie Children’s Hospital of Chicago
  • Children’s Cardiomyopathy Foundation
  • Children’s Organ Transplant Association
  • International Pediatric Transplant Association
  • National Kidney Foundation
  • Pediatric Heart Transplant Study
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UNOS celebrates 34th anniversary founding

United Network for Organ Sharing (UNOS) was founded March 21, 1984, by the leadership of the South-Eastern Organ Procurement Foundation (SEOPF). UNOS was intended to become the nation’s organ transplant network, an idea that was still in development as Congress worked on the National Organ Transplant Act. To some degree, it was a leap of faith, given that the eventual contract for the Organ Procurement and Transplantation Network (OPTN) wasn’t awarded until two years later.

In the early 1980s, organ transplantation in the United States was evolving rapidly. The pioneers of transplantation had proven that it could save and lengthen lives. But much of the science of transplantation and medical management of transplant recipients was still developing. And many transplant programs were just beginning to open up, increasing local access to care for patients across the country.

Some transplant professionals wanted to keep the field much as it had been since the 1960s. Others, including the founders of UNOS, saw the need to bring the field together in a national network, both to increase equity for transplant patients and to collect and use national data to improve transplant care. Even today, there remains healthy debate inside and outside the transplant profession about how we can best meet the needs of the patients we serve.

In the 34 years since UNOS’ founding, many things have changed. Long-term outcomes for transplant recipients have increased significantly, driven by better knowledge about matching donors with recipients and advances in treating patients both before and after the transplant. Innovations in communications technology and data analysis have revolutionized how organ offers are made and what information clinicians have in real time to make treatment decisions.

Some things remain the same. Transplantation is still the most complex form of medical care available. It relies on the cooperative efforts and skill of clinicians and professionals at different institutions anywhere in the United States, working at any hour of the day or night. And despite everyone’s best efforts, there are still many more people awaiting transplantation today than there are donated organs to meet their needs.

UNOS’ mission also remains the same, as does the focus and dedication of its staff and members. We do all we can to help those in need receive the gift of life. And we will continue to do so as long as that need exists.