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We’ve got the best organ donation and transplant system in the world. Here’s how to make it even better.

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Performance

We’ve got the best organ donation and transplant system in the world.

Here’s how to make it even better.

One of the best parts of my job is being able to tell people that America has the highest-performing organ donation and transplant system in the world. We have more organ donors and more annual transplants and we save more lives through organ donation than any other country.

Brian Shepard, UNOS CEO

“We’re not content with the status quo.”

Brian Shepard, CEO

And we’re getting better all the time. Today, American surgeons perform 40 percent more transplants than they did eight years ago. And even in a pandemic year, the system successfully performed 500 more deceased donor transplants from January through July 2020 than it did in the first seven months of 2019. Many other countries, by contrast, had steep drop-offs in the number of transplants performed this year.

Organ transplantation works for people who have end-stage organ failure. In almost all cases, it works better for people with kidney, liver, and lung failure than any other treatment available. People come to the organ donation waiting list because they know an organ transplant is a gift of life. That means that as good as our system is, it needs to be even better to be able to serve the more than 100,000 people waiting for organs at any given time.

At UNOS, the non-profit network that leads and coordinates the nation’s system of transplant hospitals, organ procurement organizations, and thousands of volunteers from the donation and transplant community, we’re not content with the status quo. Our commitment to continuous improvement has driven seven consecutive years of increases in the number of transplants performed. We also know there’s no quick fix to further strengthen a mature system with decades of experience and an infrastructure that covers the entire nation. And because we have a full view of how every step of donation and transplant works, we know that what we need now is a comprehensive set of reforms.

Earlier this year, the Centers for Medicare and Medicaid Services proposed changing the metrics by which OPOS are assessed. The proposal is well-intentioned and addresses many issues identified by the donation and transplant community. But it relies on faulty data and has met strong opposition from major stakeholders in the professional community — including the American Society of Transplantation, Association of Organ Procurement Organizations, and a number of individual transplant programs and OPOs.

And with a narrow focus on OPO metrics, CMS’ proposal does not take a broad enough look at the systemic approach that is necessary to continue to increase the number of transplants.

Because we have a full view of how every step of donation and transplant works, we know that what we need now is a comprehensive set of reforms.

Instead, UNOS proposes a five-part package of reforms, influenced by many conversations with people in the field — from surgeons and hospital staff to OPOs and organ donor families to transplant recipients and those on the waitlist. Some of these steps are within UNOS’ authority as the Organ Procurement and Transplantation Network. Others must be led by federal agencies.

These reforms would build upon our success as one of the leading systems in the world and save even more lives than ever before.

First, we need to automate real-time donor referral. This is a step we could not have proposed just five years ago. But today, hospital electronic health records give us an opportunity to have comprehensive, timely data about all potential donors. We believe we can build on that momentum and take the responsibility for referring donor candidates off the already full plates of hospital staff, who in most cases have to enter referrals manually.

UNOS and others are working to standardize a referral system that can be used by all U.S. electronic medical records providers, because automating donor referral will not only allow OPOs to identify more donors whose organs can be more quickly matched with more patients. It will also enable us to establish better metrics for OPOs and transplant hospitals.

Holding OPOs and transplants hospitals accountable for their performance and helping them to improve and save more lives requires consistent, reliable and timely metrics.

To better measure OPO performance, CMS has proposed a new metric that relies on death certificate data collected by the Centers for Disease Control and Prevention. But the CDC itself has acknowledged death certificates are not consistently accurate. They also lack the level of clinical detail OPOs, surgeons and patients need to determine donor suitability. For example, a death certificate might not tell us if the potential donor died on a ventilator or whether they had a disease that could put the transplant patient at risk. When only about 1% of people die in a way that makes them medically eligible for organ donation, having detailed information is crucial.

Automated donor referrals, on the other hand, would provide an improved, independently-reported and timely data source for understanding donor potential. This hospital-reported, patient-level data could be used to calculate a clear metric that CMS could use to assess and improve OPOs.

We also need to improve the process of getting the right organ to the right patient at the right time.

Organs sometimes go unused because the unique medical circumstances of the donor limit the number of candidates who could benefit from the organ. We’re working on a number of innovative projects to increase OPOs’ ability to place as many organs as possible, such as:

Similarly, we need to remove disincentives to using older and more complex donors when appropriate. Not every transplant candidate needs organs with the same projected life span, and one key step toward increasing organ transplantation is to use organs from older donors, which can be a good choice for some transplant patients, especially those who are older themselves. Unfortunately, today those organs are often rejected by transplant hospitals because they are more complex to work with — and by patients, who may not understand the viability of older organs.

We believe eliminating evaluation and financial disincentives for using these organs will help boost the number of transplants and save more lives.

Finally, we need to enable OPOs to merge or share services to boost their ability to serve hospitals and patients. CMS’ proposed rule provides no detailed transition plan addressing infrastructure in the service area of a decertified OPO, which could lead to ongoing disruption in parts of the country. Replacement organizations would need to rebuild the relationships and public trust necessary to maximize local organ procurement and distribution. Regulations that expedite or incentivize voluntary mergers among OPOs could expand the reach of effective OPO leadership without creating the risk of gaps in the organ recovery network.

There are thousands of things that each OPO, each transplant hospital, each staffer, UNOS, and CMS can do to drive improvement, but we’re targeting the things that we think apply to the whole system and that no individual part can do on their own. Taken together, these reforms will increase the pool of donors and organs, lead to shorter wait times and better outcomes, and mean more people receive lifesaving transplants. I’m excited by the potential for change, because as proud as we at UNOS are of the success of the organ procurement and transplant system, we know it has to keep getting better.

To learn more about the improvements we’re proposing, read the overview

5 arrows pointing up to represent increased transplants
To learn more about the improvements we’re proposing, read the overview

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Read the overview online

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Getting to yes

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Bridging the gap

The post appeared first on UNOS.

Sharing images to save more lives

internal views of organs

INNOVATION

As an organ procurement trainer at the Center for Organ Recovery and Education, Nicole Medwick is focused on making sure that the right organ reaches the right patient at the right time.

“At CORE we are always looking for new and innovative ways to improve our key processes,” she said.

So when CORE’s involvement in a medical imaging study sharing project led by United Network for Organ Sharing prompted a transplant team to accept a heart that they otherwise had planned to decline, Medwick felt proud of the work she had accomplished. “We were able to save an additional life that would not have been saved otherwise,” she said.

CORE is one of 13 organ procurement organizations (OPOs) across the country enrolled in UNet Image Sharing, a consistent, reliable and secure image sharing platform that provides OPOs and transplant hospitals universal access to high-quality medical imaging studies during the organ offer process. “UNet Image Sharing helps us share real-time images directly with transplant surgeons to help facilitate quicker decision making,” Medwick said.

First national hub

Within a year of enrolling in the pilot in 2019, her OPO was notified of an offer for a deceased donor’s heart that included a medical report saying the organ was functioning poorly. “Based on the report that we had, no one would have been likely to accept the heart,” Medwick said, but by using UNet Image Sharing, she was able to include an electrocardiogram with the offer. The transplant team analyzed the images and determined they didn’t agree with the report, ultimately deciding the heart would be suitable for transplant. “The transplant hospital staff only accepted it because they were able to look at the images and get their own read,” Medwick said.

More lifesaving organs being accepted and transplanted

Nicole Medwick

“UNet Image Sharing helps us share real-time images directly with transplant surgeons to help facilitate quicker decision making.”

Nicole Medwick, organ procurement trainer, CORE

As the first national donor imaging sharing hub, UNet Image Sharing facilitates more rapid and efficient consideration of organ offers, which can lead to more lifesaving organs being accepted and transplanted.

“UNet Image sharing streamlines the process for reviewing medical imaging studies and helps us reduce inefficiencies and the need for multiple systems,” said UNOS service owner Randall Fenderson, who has been leading the application development process and piloting the new service with members for more than two years. “As a community, we are accelerating the organ acceptance process and enabling transplant surgeons to make better, more informed decisions.”

UNet Image Sharing was created to solve a problem: If a surgeon can’t clearly see the medical imaging study of an organ that is being offered, they might hesitate to accept some offers for fear that it might not meet their patient’s needs. While well-intentioned, this risk-avoidant behavior could result in unused organs that could otherwise help save patients’ lives.

“Having images uploaded directly into UNet allows easy access for all parties involved in reviewing the quality of the organ for transplantation,” said CORE chief information officer Bruno Mastroianni. The former chair of the Association of Organ Procurement Organizations IT Council heard about the pilot in 2018 at an AOPO conference. In conversation with UNOS chief technology officer Alex Tulchinsky and IT Customer Advocacy department director Amy Putnam, Mastroianni discovered that UNOS was planning to pilot a new technology in response to members’ longstanding requests for a consistent and secure high-quality imaging sharing system that is seamlessly woven into the DonorNet platform. “I have been fortunate to have built a wonderful relationship with Alex, Amy and the rest of the UNOS team, and have volunteered to support them to pilot solutions like this before,” Mastroianni said. “It is a great opportunity to provide input and even better to work with a great partner like UNOS.”

Imaging within UNet

Between January and April 2019, UNOS piloted UNet Image Sharing with six OPOs across the country that were already using imaging solutions outside of DonorNet. “We picked OPOs that already had imaging solutions so that if something went wrong in the pilot, they still had a fallback plan that they could work with,” said UNOS business architect Rob McTier.

UNOS works with the community to improve the national system

Bruno Mastroianni

“UNOS staff listened to our input carefully to deploy multiple iterations of the solution.”

Bruno Mastroianni, chief information officer, CORE

All of the application’s functionality is available to users on the donor record in DonorNet, alongside all the other donor information. During the pilot, OPOs received high-quality imaging studies on CDs or thumb drives. They then logged into DonorNet® to upload the imaging study similar to the way they upload smaller attachments. DonorNet linked the imaging studies to a specific donor’s record. Transplant hospitals then logged into DonorNet to view the imaging study using a Digital Imaging and Communications in Medicine (DICOM®) viewing tool.

“The experience of working with UNOS was wonderful,” Mastroianni said of CORE’s participation in the pilot. “UNOS staff listened to our input carefully to deploy multiple iterations of the solution. The first version of UNet Image Sharing was good, but by listening to the pilot participants’ feedback, UNOS ensured that access worked for the right individuals needing to use the application.”

video

Faster, more informed decisions

UNOS service owner Randall Fenderson has been leading the application development process and piloting the new service with members for the past two years.

“As a community, we are accelerating the organ acceptance process and enabling transplant surgeons to make better, more informed decisions.”

Randall Fenderson, UNOS service owner

Expanding beyond the pilot

In June UNOS began making UNet Image Sharing available in a phased national rollout, first to OPOs that expressed interest in it during the pilot period, followed by OPOs in similar geographic areas to those that expressed interest. “That way, transplant hospitals are seeing a consistent way of accessing imaging studies during the transition period,” McTier said. The phased rollout also allows time for training the hospital staff that the OPOs will be sharing imaging studies with. Because of its unique position and ability to integrate all aspects of the organ transplantation system, UNOS will manage the potential impact to support personnel as new users engage with the application. There is no additional cost to Organ Procurement and Transplantation Network members.

Nearly two years since launching UNet Image Sharing, there has been a net increase in image sharing in UNet for each participating OPO, and overall. On average, 41 percent of donors from participating OPOs had images shared before the pilot started, compared to 82 percent after UNet Image Sharing began. The most uploaded type of images to UNet Image Sharing have been CT scans, followed by ultrasounds.

“There are fewer steps in the process of uploading images directly to UNet, compared to what needed to be done with our previous application,” Medwick said, adding that CORE now rarely used the external image sharing solution that they had been relying on before UNet Image Sharing was available.

In organ donation and transplantation, every second counts, and efficiency in the system leads to more lives being saved.

“UNet Image Sharing provides a consistent way for all member organizations to access images,” McTier said. “With a consistent approach, we’re hoping to accelerate the process of getting members access to images and save more lives together.”

OPOs participating in UNet Image Sharing

  • Center for Organ Recovery and Education, Pittsburgh
  • Donor Network West, San Ramon, California
  • Lifesharing: A Donate Life Organization, San Diego
  • LifeQuest Organ Recovery Services, Gainesville, Florida
  • Nevada Donor Network, Las Vegas
  • One Legacy, Los Angeles
  • Gift of Life Donor Program, Philadelphia
  • Washington Regional Transplant Community, Falls Church, Virginia
  • OurLegacy, Maitland, Florida
  • Donor Network of Arizona, Phoenix
  • Lifeline of Ohio, Columbus, Ohio
  • LifeChoice Donor Services, Waltham, Massachusetts
  • New England Organ Bank, Waltham, Massachusetts

Image uploads
as of Sept. 6, 2020

3,366
CT scans
(49.2% of total uploads)

1,755
ultrasounds
(25.7% of total uploads)

The post appeared first on UNOS.

Preservation by cold storage vs ex vivo normothermic perfusion of marginal donor hearts: clinical, histopathological and ultrastructural features.

To match clinical outcomes of heart transplantation against histopathological and ultrastructural characteristics of marginal grafts preserved by cold storage or ex vivo normothermic perfusion.

Public comment open from Aug. 4 through Oct.1.

The Organ Procurement and Transplantation Network is offering 10 items for public comment beginning Aug. 4.

We encourage patients, transplant candidates and recipients, living donors, donor families and transplant professionals to learn more about the proposals and provide valuable feedback to help shape U.S. organ transplant policy. To make the nation’s organ donation and transplantation system fair and equitable for all, many voices are needed and every view matters.

Learn more about the policy development process.

The items available for public comment this cycle are:

  • Align OPTN Policy with U.S. Public Health Service Guideline, 2020
  • COVID-19 Emergency Policies and Data Collection
  • Further Enhancements to the National Liver Review Board
  • Guidance Addressing the Use of Pediatric Heart Exceptions
  • Guidance and Policy Addressing Adult Heart Allocation
  • Modify Data Collection on Living VCA Donors
  • Modify Living Donation Policy to Include Living VCA Donors
  • Programming VCA Allocation in UNet
  • Update on the Continuous Distribution of Organs Project
  • Updated Cohort for Calculation of the Lung Allocation Score (LAS)

Educational resources, including recorded videos and presentations, will be made available Aug. 13 to provide multiple opportunities to learn more about the proposals.

Public comment closes Oct 1. All comments received about a proposed change are reviewed before the OPTN Board of Directors vote at their December 2020 meeting.

Learn about more ways to get involved.

The post appeared first on UNOS.

“Can do, passion and caring”: Jeff Orlowski on embracing change during COVID-19

As one of the 58 organ procurement organizations that serve the country’s transplant system, LifeShare of Oklahoma has helped drive a record- increase in organ donation. In 2019, OPOs recovered nearly 12,000 deceased donors, an increase of 38 percent since 2014. During that same time period, LifeShare of Oklahoma increased recoveries of deceased donors in their donation service area by 39.7 percent, exceeding the national average, according to OPTN data

While the COVID-19 crisis has impacted organ recovery and transplant, OPOs are adapting and continuing their lifesaving work. In a recent interview, LifeShare of Oklahoma president and CEO Jeff Orlowski discussed how his organization’s core values keep his team focused on the work of saving lives during the pandemic and beyond.

Q: LifeShare of Oklahoma’s core values are centered on valuing a can do attitude, having passion for the mission of saving lives and caring for teammates and the community. Your strategic anchors are people, change and relationships. How do these concepts drive your organizational approach?

We are a people-first organization. That is our guiding principle.

Our donors are people, our donor families are people, our hospitals are people, and our team are people. And so we always want to make sure that we’re making decisions in a way that will have a positive impact on people.

When I came to LifeShare, we had a tremendous amount of development to do as an organization. I asked everybody to not be intimidated by change, but instead to embrace it. Bringing change is not an indictment of what came before, it’s an acknowledgement that there is opportunity to do better. We’ve woven that theme of change through everything we’ve done for the last 8 1/2 years.

Q: What does change mean as a core value in relation to transplant?

We work in a field where change is natural. It’s happening around us constantly. There will always be new drugs, new techniques and new opportunities.

The HOPE Act is a great example. There used to be a ban on HIV positive donors—and now there’s not. I always point to the fact that in 1953, you couldn’t have a kidney transplant, and here we are less than 70 years later, and it’s been a common therapy for decades. Even more recently, when I started in the field, isolated lung transplants were just not feasible for a variety of reasons—it’s only been in the last really 30 or so years that isolated lung transplants, as opposed to heart-lung blocs have become a really viable operation. Since change happens anyway, embracing it allows us as an organization to talk about what’s possible.

All change is the result of many people working together to adapt and improve. Having change as a strategic anchor has been so important in this crisis.

Q: How have your organization’s core values helped guide LifeShare of Oklahoma through the current crisis?

Our core value of can do has served us very well. Can do is not just do it. We’re not talking about being Nike. Can do is about the fact that we’re creative. When we look at a challenge, we’ll look for alternative ways to get to the desired outcome.

In terms of the pandemic, the concept of can do has been particularly instrumental in making sure our staff were safe while we keep doing the important work of recovering donors. Protecting both staff and our mission have driven us from the very beginning. When we focused on that, we were unencumbered by any other details. We just worried about getting the job done safely. When you do that, you can be more creative and kind of let go of your preconceived limitations on yourself.

We have 135 staff between our Oklahoma City and Tulsa offices, and during this crisis we have had to lean into real change as an organization­—with amazing results.

Q: What are some of the changes your executive team made to adapt in response to COVID-19?

That first weekend of March 13, we started mainly trying to get our clinical staff converted to telecommute so they wouldn’t cross-contaminate one another. Their safety was a priority in those early discussions, but we didn’t really understand then what we were up against compared to what we knew just a few weeks later.

After that I took a step back and started assessing the global organizational impact. That was when staff safety and well-being started to become the guiding principle, and it was pretty easy to see how we could keep doing our mission.

Q: What do you think will be some of the permanent changes that result from the crisis?

I think one of the silver linings is that it has forced the community to rethink the concept of jumping on a jet in the middle of the night, flying a couple hours and riding around in the back of an ambulance to accomplish something that can be accomplished without everyone traveling. That’s not just OPO staff—our transplant partners are rethinking letting a local recovery surgeon recover and send an organ, because that means they can also avoid flying. This is a benefit overall in terms of broader allocation—if we can avoid putting a surgeon and a perfusion staff member or surgical recovery coordinator on an airplane for two hours one direction, and then sitting around at a hospital, waiting for everything to go and then doing the case, and then two hours more on a plane back, then those people can be home tucked in bed and fresh and wide awake when it’s time to do the transplant. We keep the transplant team safe and rested, and we make maximum use of our resources so that more lives are saved.

Q: You have spoken internationally about organ donation and recovery in the United States. What are your observations about how the U.S. system adapted to COVID-19 compared to other countries?

The COVID-19 crisis has actually illustrated how effective American OPOs are.

Other countries saw donation and transplantation basically grind to a halt, which was not the case in the U.S. We had considerably higher rates of transplants than many other countries that were tremendously impacted by this, which I think is a testament to our ability to refocus and reinvent ourselves in order to keep people getting transplanted.

When we evaluate opportunities for improvement, we must acknowledge that we’re improving from a position of strength. We’re fortunate to have extremely bright and capable people who, when faced with an unprecedented pandemic, have been able to continue to save lives through donation and transplantation through a massive amount of collaboration and teamwork, on a national level. While we always need to strive for improvement, we shouldn’t underestimate the factors that make us so successful already.

Jeff Orlowski is president and CEO of LifeShare of Oklahoma, and president of the LifeShare Foundation. He currently serves as the Organ Procurement and Transplantation Network Region 4 associate councillor, and is a member of the OPTN Membership and Professional Standards Committee. A past president of the Association of Organ Procurement Organizations and Donate Life America, Orlowski has 33 years of experience in organ and tissue donation and has co-authored more than 40 peer-reviewed articles. Orlowski earned a bachelor’s degree in biology from the University of Kansas and a master’s degree in management from Regis University.

The post “Can do, passion and caring”: Jeff Orlowski on embracing change during COVID-19 appeared first on UNOS.

Making organ recovery transportation safer for transplant teams

in focus

Despite a decade since a 2007 fatal plane crash involving a University of Michigan transplant team and pilots, there remain no federal standards regulating air and ground transportation of organ recovery personnel.

The American Society of Transplant Surgeons, the American Society of Transplantation, the Association of Organ Procurement Organizations, and United Network for Organ Sharing convened to develop national transportation standard recommendations.

In an article published in the April issue of the American Journal of Transplantation, University of Iowa kidney surgeon David Axelrod, M.D., United Network for Organ Sharing CEO Brian Shepard, and other members of the organ donation and transplant community summarized their discussions and defined national standards for organ recovery practice in three areas: air transportation, ground transportation and insurance coverage.

Recommendation highlights included:

  • Expanding air transport quality assurance protocols, including a requirement for twin-engine, turbine-powered aircrafts piloted by two qualified pilots and operated by organizations that have been certified through onsite inspections
  • Ensuring teams travel in dedicated vehicles with adequate safety restraints; ambulances are avoided whenever possible; and, the use of lights and sirens during transport is minimized
  • Providing adequate insurance coverage for all organ recovery team members, including trainees

New organ allocation policies that mandate broader sharing have highlighted the need to formalize transportation safety protocols as an essential element of the national standards followed by all transplant teams. The organ donation and transplant community members convened in 2008 to develop standards meant to ensure the safety of transplant team members and organ procurement organization personnel who travel to recover lifesaving organs.

Read the abstract

Axelrod DA, Shah S, Guarrera J, et al., Improving safety in organ recovery transportation: Report from the ASTS/UNOS/AST/AOPO transportation safety summit. Am J Transplant. 2020;00:1–8. doi:10.1111/ajt.15930

In focus


Despite a decade since a 2007 fatal plane crash involving a University of Michigan transplant team and pilots, there remain no federal standards regulating air and ground transportation of organ recovery personnel.

The post appeared first on UNOS.

COVID-19 pandemic ignites collaboration in the transplant community

in focus

UNOS collaborated with nine global transplant organizations and societies on four COVID-19 organ donation and transplant town hall webinars that have received more than 25,000 views.

Organ donation and transplantation organizations acted swiftly to produce town hall-style webinars.

As COVID-19 cases began increasing globally, conversations among health care providers about the pandemic’s potential impact on transplant started to emerge.

Within a few days, organ donation and transplant communities from around the world assembled to collaborate on a webinar series sharing real-world, global experiences for the organ donation and transplant community. Along with United Network for Organ Sharing, participating organizations included:

The societies launched their first live, collaborative webinar “COVID-19: Organ Donation and Transplant Town Hall,” on March 23, and the 1,000 available seats filled up within a few hours. Collaboration continued over the following weeks with three additional webinars, covering topics ranging from:

  • Presentation, diagnosis, treatment and prevention
  • Getting to transplant
  • Operational issues
  • Screening donors and candidates
  • Protecting the workforce
  • Ethical issues

The societies aren’t done yet, with future plans to produce more collaborative webinars on navigating COVID-19, as well as topics unrelated to the pandemic.

Read more about the COVID-19 pandemic and collaboration within the transplant community.

In focus


Organ donation and transplantation organizations acted swiftly to produce town hall-style webinars that have been viewed more than 25,000 times.

The post appeared first on UNOS.

How the COVID-19 pandemic spawned collaboration in the transplant community

A Q&A with American Society of Transplantation immediate-past president Emily Blumberg, M.D.

“I would have never foreseen the incredible positive force that such a collaboration could generate. I think it all made us feel we were doing something important for the community.”
Emily Blumberg, M.D., immediate-past American Society of Transplantation president

As COVID-19 cases began increasing globally, conversations among health care providers about the pandemic’s potential impact on transplant started to emerge. “This sense of the need to educate our communities—both individually and potentially as a group—came up, and we started sending around emails amongst ourselves,” said transplant infectious disease specialist Emily Blumberg, M.D., who recently served as president of the American Society of Transplantation.

Within a few days, organ donation and transplant professionals from around the world had assembled to collaborate on a webinar series sharing real-world, global experiences for the organ donation and transplant community.

“COVID-19 presented a unique opportunity for us to convene not only transplant associations in the United States, but across the world,” said former UNOS Board of Directors president Stuart Sweet, M.D., Ph.D., who recently concluded his term as president of the International Society for Heart and Lung Transplantation. “It was really taking advantage of a challenging opportunity to convene our community in a way that we’d never done before.”

Registration for the first live, collaborative webinar “COVID-19: Organ Donation and Transplant Town Hall,” launched on March 23 and the 1,000 available seats filled within a few hours. Collaboration continued over the following weeks, with three additional webinars covering topics ranging from protecting the workforce to conversations around testing. Collectively, the webinar recordings have been viewed more than 25,000 times.

In a recent interview, Blumberg talked about how the organ donation and transplantation community united amidst the COVID-19 pandemic to launch the webinar series.

How did the idea for the collaborative COVID webinars come to be?

I’ve been thinking back about how this started and honestly, I think there were a lot of side conversations that happened among leadership of these different organizations. But somehow, organically, this sense of the need to educate our communities—both individually and as a group—came up, and we started sending around emails amongst ourselves. All of a sudden we had a group of committed individuals who thought that we should try to share information in real time. There was tremendous brainstorming about speakers at every juncture and how to make it international. I think people were just really interested in helping to meet the challenge of COVID with information to the best of our ability in real time.

What was the goal?

The first goal was to disseminate current information from people who were already experiencing the management of transplant patients with COVID-19. We wanted to have people who could give us real world experiences and who would have a perspective to help pave a way for everybody else to start thinking about it. One of the incredible things about the webinar was having the international components provided by several of the societies. Especially with everything that has gone on in Italy, ahead of us, in terms of experience. We could actually engage people who knew a little bit more about what they were seeing and how they were handling it and get some real-time, practical information. I think this is something that would never have been doable if we had tried to stay local.

How did everything come together?

On our first call, we were brainstorming about different topics that people were interested in hearing about and that we thought would be helpful, and where different members of the societies were experience-wise. We made an enormous list of these. Then we pared the list down and tried to make it into a cohesive whole. We really benefited a lot from UNOS their willingness to use their platform. Because UNOS had the technology already set up, that became an immediate weight off everybody’s shoulders about how we were going to do this. It also took out of any individual society’s purview, which I think helps the collaboration and made it easier. We asked everyone to come in with three really relevant slides and five minutes of critical information. It really focused the individuals and allowed us to bring many more viewpoints.

What was the experience like working with so many societies?

I don’t think anybody, at any point, saw this as owned by any individual society. I think we all appreciated what all the different societies had to contribute and their commitment to it. It’s an extraordinary group effort. Personally, I knew some of the people involved in advance of the webinars, but there were people I’ve met through this experience who it’s been such a pleasure to collaborate with. I think that could be said for all of us.

What surprised you most about the collaboration?

I’ve been impressed by how engaged people have stayed throughout the entire process. It wasn’t like the first one was done and everybody checked out. We realized people were really interested and it made people engaged in doing another one. When we did the second one and the extra module for it, we said, “Wow, people are still interested.”

How do you think this collaboration has helped the transplant community as they navigate COVID-19?

We’re all benefiting from learning from everybody’s experience for sure. I mean, there have been some difficult times for all of us. Having this information to fall back on has been really beneficial. Just in our day-to-day jobs in taking care of patients, setting up things in our various transplant hospitals and trying to learn from people’s experience so you’re not starting at the bottom. You’re actually starting with the foundation that you’ve gained from interfacing with people throughout the world.

What do you hope the community has gained from these events?

I think we’ve gotten to know one another a little better and feel more globally joined as a community, in a way that maybe we didn’t feel so much before. The societies have interacted one-on-one with other societies on certain initiatives, but this experience let us know that people are interested in a bigger world. Not that the societies individually are going away, but that they’re finding new ways to collaborate and we’re all learning from one another.

What’s your hope for the future?

I’ve talked individually with some of the other leaders of other societies and I think we would like to try to continue some level of international education. I hope that we’re going to be able to talk in the next week or two to figure out what our next steps are going to be. I think it would be nice to expand this tent to include more people.

This was one of the most exciting things that I’ve gotten to participate in during this past year. I would have never foreseen the incredible positive force that such a collaboration could generate. I think it all made us feel we were doing something important for the community. We all had a common goal and a common interest and it was really a pleasure.

The post appeared first on UNOS.

COVID-19 updates: April 24, 2020

Patient Q&A with UNOS Chief Medical Officer David Klassen

Navigating the coronavirus pandemic is difficult for everyone, but brings special challenges for transplant patients. In a new video series on TransplantLiving.org, UNOS Chief Medical Officer David Klassen, M.D., answers questions for patients about COVID-19 and the waiting list, temporary inactivation, donor testing, living donation and other important topics.

Reactivation process for multiple kidney transplant candidates now available

As of April 22, kidney transplant programs are now able to simultaneously perform reactivation of multiple candidates whose current status is “Temporarily Inactive (7),” with inactive reason “COVID-19 Precaution.” Details and directions were sent via email to staff at all kidney transplant programs and posted on Secure Enterprise. In addition, step-by-step instructions are available in online help in UNetSM.

Programs also have the ability to perform temporary inactivation of multiple transplant candidates simultaneously for the reason of “COVID-19 Precaution,” which was released March 27. Together, this set of tools ensures offers are made efficiently to candidates who are immediately eligible for a transplant and streamlines the offer process.

Before temporarily inactivating candidates, please reference OPTN policy 3.6.A for information about whether candidates needing a particular organ type accrue waiting time while inactive.

ISHLT presents new webinar: COVID-19 and challenges in advanced heart and lung disease and cardiothoracic transplantation

The International Society for Heart and Lung Transplantation is holding a free, live webinar for the cardiothoracic transplant community on April 29 at 4 p.m. ET. A recording will be posted for later viewing. Membership is not required and CE credit is available.

UNOS Staffing Survey deadline extended through Dec. 31

The deadline for the UNOS 2019 staffing survey has been extended from May 31 to Dec. 31. The extension is in response to the COVID-19 pandemic and will ensure maximum participation from as many hospitals as possible.


Reminders

COVID Collaborative now open for registration

The OPTN launched an interactive forum on April 22 so that members may engage on topics specific to donation and transplant during COVID-19. The OPTN COVID Collaborative operates on a secure online communication platform and allows donation and transplant professionals to collaboratively discuss, organize, catalog and archive the learnings and insights developed during the 2020 pandemic.

The site will:

  • Offer discussion forums, facilitated by collaborative improvement specialists
  • House and organize the member-driven information that results from this collaboration
  • Be available for the duration of COVID-19, or until the decision is made to close the project
  • Deploy national and regional webinars to support the spread of effective practices that emerge from site discussion

Participation in the COVID Collaborative is limited to individuals from OPTN member organizations. Registration is required. The scope of discussions will include OPTN member business and administrative processes related to the management of COVID crisis, and discussions will be moderated. Members with questions about policy during the pandemic should email member.questions@unos.org. Members with questions about policy compliance during the pandemic should email MQFeedback@unos.org.

Members may register here. Participants will receive an email with account and login information within two business days of registering.

For more information about the OPTN COVID Collaborative, email covidcollab@unos.org

Temporary changes to transplant program member monitoring as a result of the pandemic

MPSC leadership has evaluated specific areas of monitoring that are raising particular concern within the community. In an effort to encourage transplant programs to use their clinical judgement about what is in the best interests of their patients without the added concern of strict compliance with OPTN obligations, the MPSC will implement several time-limited emergency changes to member monitoring. These include:

  • Suspending functional inactivity reviews through Sept. 30
  • Placing a temporary hold on reviews of patient notification of extended waiting list inactivity and transplant program inactivation through Sept. 30

All time-limited COVID-related updates to monitoring changes may be found in a supplement to the OPTN member evaluation plan on the OPTN Compliance page. This document serves as a quick-reference guide to all member monitoring changes implemented as a result of the pandemic. It will be regularly updated with any additional monitoring changes implemented during this event.

Site surveys

Site surveys will be conducted virtually at least through the end of June. Any member who is not able to participate in a survey at this time can request a delay by emailing MQFeedback@UNOS.org

Patient safety portal reporting

Remember to report any suspected transplant-related disease transmissions through the Patient Safety Portal. At this time, the major transplant societies (AST, ASTS, AOPO, TTS) recommend against transplanting organs from a donor who has tested positive for COVID-19 from a respiratory tract sample or the blood, as this is likely indicative of an active infection that could be transmitted to a recipient, organ procurement team, transplant team or other contact.


New resources

Stay current

We will continue to update the UNOS COVID-19 resources page as guidance is developed and enhanced.

The post appeared first on UNOS.

Updates to OPO notification limits for electronic notification for heart, lung, and heart-lung matches

Audience

  • OPO directors, administrators, data coordinators and clinical coordinators
  • Please share this notice with anyone in your organization who would benefit from this information.

Implementation date: April 6, 2020

Updates for electronic organ offer notifications provide additional efficiency and flexibility about how to offer organs

An update has been made for OPO electronic organ offer notification limits in DonorNet® to provide additional efficiency and flexibility to make informed decisions about how to offer organs using their own defined best practices. Revised heart and lung policies no longer use the donation service area (DSA) as the first unit of allocation, and therefore candidates at the top of the match runs may include potential recipients who are beyond the DSA border.

What you need to do

Directions were included in an e-mail sent April 6 to all OPOs and are posted in a system notice in Secure Enterprise.

 Additional resources

DonorNet® online help documentation has been updated so that OPOs will have access to the information about how local limits are used for heart, heart/lung, lung and liver matches.

Questions?

If you have questions relating to implementation, contact UNOS Customer Service at unethelpdesk@unos.org, or call 800-978-4334 from 8 am to 7 pm EST.

For policy-related questions, contact member.questions@unos.org or call 844-395-4428.

The Organ Center is available around the clock and can be reached at 800-292-9537.

The UNOS COVID-19 resources page is refreshed regularly with the most current updates and resources. Please check back frequently for updates

 

 

The post appeared first on UNOS.