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Liver and Intestinal Organ Transplantation Committee Spring 2014

Proposed Membership and Personnel Requirements for OPTN Designation & Approval of Intestine Transplant Programs. Liver and Intestinal Organ Transplantation Committee Spring 2014. Problem Statement.

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Liver and Intestinal Organ Transplantation Committee Spring 2014

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  1. Proposed Membership and Personnel Requirements for OPTN Designation & Approval of Intestine Transplant Programs Liver and Intestinal Organ Transplantation Committee Spring 2014

  2. Problem Statement • No OPTN/UNOS requirements exist regarding who may perform intestine transplants and care for intestine transplant recipients • Currently, any transplant program that is approved to perform liver transplants can perform intestinal transplants upon submitting a written request to UNOS membership department

  3. Goals of the Proposal • Define a designated intestine transplant program • Establish minimum qualifications for primary intestine transplant surgeons and physicians • Done without compromising quality or restricting new program formation

  4. Additional Background • Prior Proposal: August 2006 • Not well-supported, withdrawn • Concerns from 2006: • Many well-qualified programs would not meet requirements • Did not contain a transition plan for existing programs

  5. Additional Background • Current Proposal • Lower thresholds • Full approval and conditional approval pathways

  6. Supporting Evidence • Low-volume procedure with most programs performing fewer than 5 IN or LI-IN transplants in 2012 • Thresholds not derived from statistical analyses • Represent level of experience to set minimal standards without restricting access or new program development • Similar to initial thresholds for other organs

  7. Summary ofProposed Bylaws

  8. Primary Surgeon Experience Pathways

  9. Primary Physician Experience Pathways

  10. Provision for Combined Adult/Ped Programs • Primary pediatric IN transplant physician can function as primary adult IN transplant physician if an adult gastroenterologist is also involved in the care (if in same program) • If no qualified pediatrician on staff: • Adult IN transplant physician can function as primary Pediatric IN transplant physician pediatric if a gastroenterologist involved in the care • Programs serving predominantly pediatric patients should have a board certified pediatrician who meets the criteria for primary IN transplant physician

  11. Centers Performing at Least One Intestine Transplant 2009-2013 (n = 26 “active” out of 41 registered IN programs)

  12. What Members will Need to Do • On a given date ALL current intestine transplant program designations will terminate • At least 120 days before the termination date an intestinal transplant program application will be available • Members must submit an application and receive approval by the termination date in order to perform intestine transplants

  13. Questions? • David C. Mulligan, MD Committee Chair david.mulligan@yale.edu • Name Region # Representative Email • Ann Harper Committee Liaison ann.harper@unos.org

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