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Explore solutions for liver distribution disparity with metrics, options, and work plan updates from UNOS. Join the cause for a balanced and fair organ distribution system.
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UNOS UpdateRegion 8 David Klassen, MD Chief Medical Officer, UNOS March 10, 2017
COIIN initial cohort 14 OPO partners
Miami Meeting: Paths to Consensus Because solving this problem is a responsibility that comes with the leadership role our community has been given in OPTN: Attendees with diverse viewpoints discussed principles related to geographic disparity and liver distribution: • Supply/Demand Metrics • Disparity, Outcome and Access Metrics • Logistics, Finances, Post-Implementation Monitoring • Solutions and Implementation Strategies 5 8 2 3 7 1 4 6
Supply / Demand Metrics • Important to Agree on the supply/demand metrics used as inputs to potential solutions • Recommended choosing metrics free of influence from DSA performance (supply) and center listing practices (demand) • Recommended the Liver/Intestine Committee explore data available from the CDC / National Center for Health Statistics for this purpose • The these metrics will then be used to generate new supply/demand ratio “heat maps” demonstrating the geographic variability by DSA/Region.
Liver Distribution Options The Liver/Intestine Committee has asked the SRTR to model the following options: • Concentric Circles • Sharing to all transplant centers within a fixed distance from the donor hospital • Share M/P 29+, 500 mi circles, 3 M/P Proximity points in 150 mi circle or DSA • 8 Districts • Optimized redistricting • Share M/P 29+, 3 M/P Proximity points in 150 mi circle or DSA • Neighborhoods • Optimized DSA based sharing • Share M/P 29+, 3 M/P Proximity points in 150 mi circle or DSA • The Committee may consider a Seth Karp / Will Chapman directed sharing idea if developed in a suitable time frame 5 8 2 3 7 1 4 6
2017 Board of Directors Election • 2017 President Yolanda Becker • Vice president/president-elect Sue Dunn • Treasurer David Reich • Minority Transplant Rep Akinlolu Ojo • Patient and Donor Affairs Representatives: • William Freeman • Macey Henderson • Tara Storch
Goals for 2018-2019 Board Improve diversity for a better overall balance in: • skill sets and professions • minority and gender representation • patient/donor backgrounds
Positions Open on 2018-2019 Board • Vice President/President-Elect • Vice President of Patient Donor Affairs • Secretary • Patient/Donor Affairs Reps (4) • At-Large MDs • Specialties needed: pediatrics, thoracic, transplant medicine specialties (nephrology, hepatology, etc) • General At-Large • Committee specifically requests professionals in transplant administration and health care finance
Call for nominations: 2018-2019 Board of Directors • Now-August 2017 Individuals submit interest form • After August 1, 2017 Nominating Committee begins reviewing interest forms • December 2017 Nominating Committee recommends to Board a final slate of nominees for approval • February/March 2018 Board elected by vote of members through national electronic ballot • July 1, 2018 New Board members begin term
UNOS Labs: bringing behavioral science to the matching system Source: www.irrationallabs.org
UNOS Labs Mock Offer Simulation System • Web-based application designed for experimentation • Goal is to have similar look, feel, and content as current DonorNet • Pursuing a “near real-world” offer decision-making environment • Mobile phone and PC friendly • Prototype system under development Would you be interested in contributing to this science by receiving and responding to mock organ offers? email unos.labs@unos.org
Data Portal Visualizations and Reports • Launched a new, secure data portal within UNet in December 2015. • Members are able to access automated reports updated at least monthly. • Report on Organ Offers released in December 2015 in both Tableau and Excel format. Updated weekly. • Other reports currently in “My Data Files” includes ABO Validation and Outcomes of Transplanted Organs. • New reports coming soon: • Data submission compliance (CMS and OPTN) • US waiting list by zip code of residence. • Donors recovered with fields included in SRTR OPO reports. Report on Organ Offers
UNOS Data and Quality services • Customized OPO local utilization dashboards • Market impact analyses for OPO/transplant centers considering organizational changes • Customized, mini-primers • Transplant data boot camp trainings • Data coordinating center contracts for clinical trials • Registry development and management for regional/national collaboratives • International consulting/training seminars • Comprehensive transplant center activity dashboards • Transplant center service line analytics consulting
2016 Financial Results • Total FY2016 OPTN expenses totaled $45,995,581 • Registration fees provided 88.5% of funding. • Federal appropriations 11.5% of funding 2016 Actual 2016 Budget 2015 Actual 54,109 56,066 53,417 1,957 registrations ($1.6 million) below budget
FY 2017 finances • Registration Fee increased from $957 to $979
FY 2017 finances Looking at year over year changes, there has been a steady decline in kidney listings with <1 year of dialysis, but in 2016, there was a stark shift in additions with 1-<3 years of dialysis. Indicative of possible “rebound” or “catch-up”? Decreasing since 2013 Post-KAS Increase Recent shift to increase Note: Bar represents percent change from previous year, while number represents number of registrations during calendar year.
UNOS UpdateRegion 8 David Klassen, MD Chief Medical Officer, UNOS March 10, 2017