Region 4 Meeting

1. Region 4 Meeting Adam Bingaman, MD, PhD Regional Councillor

2. Meeting agenda • Update from OPTN/UNOS leadership • Regional discussion session – New! • Living Donation • OPO Dashboard • System Optimization • Review and discuss 3 public comment proposals and 1 white paper • Your feedback will be shared with the Ethics, Kidney and Liver Committees • Updates on committee activities: Kidney, Liver, Transplant Coordinators

3. Regional Business • Summary of fall 2016 regional meeting • Why should you review it? • Committee’s response to our region’s comments • Board’s action on each proposal • Information on implementation date

4. Fall regional meeting date • Fall public comment: July 31 – October 2, 2017 • proposals will go to the Board for review in December • Fall 2017 region 4 meeting: August 25, 2017 in Dallas • Mark your calendar!

5. Region 4 Meeting Attendance

6. Regional Business • Councillor responsibilities • Moderate regional meetings, oversee regional business • Serve as the region 4 representative to the OPTN/UNOS Board of Directors • Present the region’s feedback on public comment proposals and other OPTN/UNOS matters • To best represent the region, I need to hear from you • Welcome members of the Board of Directors

7. OPTN/UNOS Committee Nominations • Nominations reviewed by regional nominating committee • Election ballot sent to regional voting members • Committee leadership is reviewing committee rosters, and finalizing for OPTN President-Elect review • Purpose: ensure staffing needs of the committees are met, and expertise needed for project work is represented • President-Elect reviews the membership of all committees • Purpose: goal is for the committee system to represent the community we serve - balance of professions, opinions, race, gender • New committee members will receive notice by early April

8. OPTN/UNOS Committee Recommendations • Liver and Intestine Transplantation Committee – John Goss, MD • Minority Affairs Committee – Richard Ruiz, MD • Operations and Safety Committee – Ben Keebler, EMT-P • OPO Committee-Chad Ezzell, CPTC, CTP • Pancreas Transplantation Committee-Matthew Mulloy, MD • Pediatric Transplantation Committee-TamirMiloh, MD • Thoracic Transplantation Committee – Shelley Hall, MD • Transplant Administrators Committee-Betsy Stein • Transplant Coordinators Committee- Christopher Schwatrz

9. Committee Representation2015-2016 vs. 2016-2017: Demographics

10. Our region’s nominations from the fall

11. Some of the challenges with the current Committee structure • 11 of 18 individuals on most Committees are selected by a group other than the committee and OPTN leadership • Lack of diversity (perspectives, demographics, professions) due to disjointed appointment process • Review all committee rosters to identify specialties and demographics that are underrepresented

12. Regional Meeting Agenda: Discussion • Discussion agenda format is the same as previous meetings • 3 public comment proposals and 1 white paper • Presentation • Discussion • Regional Vote

13. Regional Meeting Agenda: Non-Discussion • Includes proposals anticipated to be: • non-controversial, • minimal impact on the transplant community, and/or • represent a clerical change to clarify policy or remain current with clinical practice • Region was offered an opportunity to request that a proposal(s) be placed on the discussion agenda • There were requests to move the White Paper on Financial Incentives to discussion • The remaining proposals will be voted on today, but not presented or discussed • Proposals presented and discussed during national webinars

14. National Webinars • Two webinars to present and discuss the proposals and white paper on non-discussion agenda • Monday, February 27, 2:00-3:00 pm ET • Registration information located on Transplant Pro

15. Non-Discussion Proposals: VoteYou have the option to abstain from voting if you haven’t reviewed the proposals • Rewrite of Bylaws Article II: Board of Directors (Executive Committee) • Histocompatibility Testing Guidance Document(Histocompatibility Committee)

16. Public Comment Proposals • Public comment booklets on each table • All attendees may discuss and provide feedback • Each OPTN/UNOS member institution has one voting representative • Sponsoring committee considers regional feedback in development of final proposal • Board receives all public comment • Your feedback is important!

17. Public Comment Opportunities • Contact Regional Representatives • List is located on Transplant Pro: select the community tab, and then “regions” • Submit public comment online • OPTN website: http://optn.transplant.hrsa.gov/governance/public-comment/ • blog-style format, • individual, regional, and committee comments are published

18. Regional Meeting Materials – online! • The presentations presented today are posted on Transplant Pro • Make sure to review the presentations that weren’t presented today • Histo, OPO, Pancreas, Patient Affairs, Pediatric, Transplant Administrators, Thoracic, VCA • Additional information available on this website including: • Meeting agenda and summaries • Data • Links to various OPTN resources

19. Regional and National Data

20. Deceased Donation 2015-2016U.S.

21. Deceased Donors by Type and Region2016

22. Deceased Donation 2015-2016Region 4

23. Deceased Donors by Type2007-2016Region 4 44%

24. Deceased Donor Transplants 2014-2016 U.S.

25. Deceased Donor Transplants 2014-2016 Region 4

26. Framing the day • We want feedback from as many attendees as possible • Please actively participate in the regional discussion session! • During the discussion of each proposal, please limit your comments to new comments - points that haven’t been raised • Please hold your comments and questions until the end of each presentation • If the region opposes a proposal, specific feedback is valuable regarding the reason for opposition and any modifications the committee could make

27. Questions?