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OPTN Board approves pediatric transplant program components, strategic planning, operational actions

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UNOS News Bureau

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The Board of Directors of the Organ Procurement and Transplantation Network, at a virtual meeting held Dec. 7, approved pediatric components for 268 heart, kidney, liver, lung and pancreas transplant programs. Effective Dec. 8, any candidate younger than age 18 must be listed at one of these programs unless an exception is made for a very medically urgent heart or liver candidate. The searchable member directory on the OPTN website will display programs with a pediatric component.

“This is a key milestone in promoting the safety and efficiency of transplantation for children in need of a transplant,” said David Mulligan, M.D., president of the board. “The requirements were developed carefully to ensure that these programs have highly trained and experienced clinical staff and appropriate facilities to care for the specific needs of pediatric candidates and recipients. The application and review process took place in a staged fashion to allow programs interested in applying to take any needed steps to ensure they would qualify.”

Strategic planning

The board heard an overview of ongoing development of the OPTN Strategic Plan for 2021 through 2024. The OPTN Executive Committee will circulate a draft plan for public comment in January 2021, and a proposed final plan will be presented for board action in June 2021. As currently envisioned, there are four overall strategic goals:

  • Increase the number of transplants
  • Provide equity in access to transplants
  • Promote living donor and transplant recipient safety
  • Improve waitlisted patient, living donor, and transplant recipient outcomes

COVID-19 operational actions reviewed, will remain in effect

The board reviewed several operational actions adopted by the OPTN Executive Committee in March and April, 2020, to help members document COVID 19-issues affecting organ donation and transplantation and to help members focus needed resources on essential clinical services. The board agreed to make permanent a requirement for OPTN members to document COVID-19 testing for all potential deceased donors. The board resolved that the following measures will remain in effect, subject to ongoing Executive Committee review for their applicability and effectiveness:

  • Updates to transplant candidate data if a transplant hospital is unable to bring a candidate in for updated lab testing due to COVID-19 issues
  • Relaxation of certain data submission requirements for follow-up of transplant recipients and living donors
  • Modifications to reporting wait time initiation for kidney transplant candidates who are not on dialysis

Other actions

The board took additional actions as follows:

  • Approved new and amended OPTN policies to align with recently updated recommendations from the U.S. Public Health Service to assess organ donors and monitor transplant recipients for potential HIV, hepatitis B and hepatitis C infection
  • Endorsed a slate of nominees for election to open positions on the board for terms beginning July 1, 2021
  • Approved the programming into the UNetSM system of allocation policy for vascularized composite allografts (VCA)
  • Modified data collection requirements for living VCA donors
  • Accepted new guidance and updated policy regarding adult heart allocation, to standardize and streamline data reporting for candidates with certain clinical conditions
  • Adopted guidance addressing the use of exception requests for pediatric heart candidates
  • Approved additional updates to operational processes and guidance for the National Liver Review Board, to clarify guidance and better ensure expert review of exception requests
  • Updated the cohort of data used to calculate the lung allocation score
  • Amended the OPTN Bylaws to permit all members of the board to vote on the full slate of representatives to the OPTN Executive Committee