definition of transplant policy oversight committee (poc) fall 2014
TRANSCRIPT
Definition of Transplant
Policy Oversight Committee (POC)Fall 2014
Questions from OPTN/UNOS members What is the definition of a transplant? Which date should be reported as the transplant date?
Current disconnect between policy definitions and clinical practices
Proposed definitions will help align policy requirements with current clinical practice
The Problem
Patient receives liver transplant, but organ is larger than expected. Surgical team does not immediately close the abdomen. Patient is removed from the OR and dies three days later.
Disconnect: According to current policy, the transplant was never completed
The Problem – Single Organ Transplants
Recipient leaves OR after receiving first organ transplant and returns to OR next day for a second organ from same donor
Current policy: date of 2nd organ transplant recorded as date of first organ’s anastomosis first transplant could have occurred more than 24 hours
earlier
Disconnect: program could need to remove a patient from waiting list before the second organ is transplanted
The Problem- Multi-organ Transplants
Maintain current reporting elements, while capturing existing clinical practice
Ensure data reported to the OPTN reflect what actually happens in a single-organ or multi-organ transplant
Goal of the Proposal
Definition of Organ Transplant
An organ transplant BEGINS at anastomosis of the organ, and an organ transplant would be COMPLETE when:
The cavity is closed and final stitch or staple applied or
The recipient leaves the operating room, even if the chest or abdominal cavity cannot be closed
How the Proposal will Achieve its Goal
Definition of Transplant Date:
Transplant date for an organ would be determined by the start of anastomosis for that organ, so you could have a multi-organ transplant occur on two different days
The beginning and completion of an islet infusion would not change
How the Proposal will Achieve its Goal
Accurately report data based on the proposed language
Apply the new definitions of organ transplant and transplant date when reporting in UNetSM
What Members will Need to Do
Yolanda Becker, MDChair, Policy Oversight Committee
Leigh A. Kades, MA Liaison, Policy Oversight Committee
Questions?