Liver and Intestinal Organ Transplantation Committee Spring 2014
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Proposed Membership and Personnel Requirements for OPTN Designation & Approval of Intestine Transplant Programs Liver and Intestinal Organ Transplantation Committee Spring 2014
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Proposed Membership and Personnel Requirements for OPTN Designation & Approval of Intestine Transplant Programs. Liver and Intestinal Organ Transplantation Committee Spring 2014. Problem Statement. - PowerPoint PPT Presentation
Transcript of 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
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
Problem Statement
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
Goals of the Proposal
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Prior Proposal: August 2006 Not well-supported, withdrawn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
Additional Background
Current Proposal Lower thresholds Full approval and conditional approval pathways
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
Supporting Evidence
Summary ofProposed Bylaws
For OPTN approval, the Transplant Hospital must have current approval as a Liver Transplant Program
Identify a designated physician or surgeon to act as the Transplant Program Director
Identify a qualified primary transplant surgeon and physician
Designated Intestine Transplant Program
A Designated Intestine Transplant Program must have a primary surgeon who meets all of the following requirements:
M.D., D.O., (or equivalent from another country), current medical license in hospital’s state or jurisdiction
Accepted on the hospital medical staff, on site at that hospital, in good standing
Documentation from the hospital credentialing committee verifying state licensure, board certification, training, and transplant CME
Primary Surgeon Requirements
Current certification by the American Board of Surgery, the American Board of Osteopathic Surgery, or the International Board of Medicine and Surgery (IBMS)
Must have completed at least one of the training or experience pathways
Primary Surgeon Requirements (Cont’d)
Full Approval Conditional Approval
At least 7 IN transplants as primary surgeon, 3 in past 5 years
Performed at least 3 IN procurements, at least 1 liver-inclusive recovery
Direct involvement in IN transplant patient care w/in last 2 years
Training: ASTS-accredited program (or appropriately trained foreign graduate)
At least 4 Intestine transplants in the previous 5 years and then 3 intestine transplants over the next 3 consecutive years
Performed at least 3 intestine procurements with at least 1 liver-inclusive recovery
Direct involvement in intestine transplant patient care within the last 2 years
OR Proctor/Mentor Relationship
Primary Surgeon Experience Pathways
Full Approval Conditional Approval Direct involved in primary care of
at least 7 newly transplanted intestine recipients, followed for a minimum of 3 months
Direct involvement in intestine transplant patient care within the last 2 years
Observed at least 1 isolated intestine transplant and 1 combined liver-intestine or multi-visceral
Directly involved in primary care of at least 5 newly transplanted IN recipients, followed for a minimum of 3 months
Directly involved in IN transplant patient care within last 2 years
Observed at least 1 isolated intestine transplant & 1 combined liver-intestine or multi-visceral transplant
12 months experience (active intestine transplant service) as primary intestine transplant physician or under direct supervision of a qualified intestine Transplant physician within a 24-month period
Demonstrate progress towards meeting full requirement (care of 7 intestine transplant recipients)
Primary Physician Experience Pathways
Adult & pediatric components in same Program: Primary pediatric IN transplant physician can function as
primary IN transplant physician for the adult component, if an adult gastroenterologist is also involved in the care
Programs serving predominantly pediatric patients: Should have a board certified pediatrician who meets the
criteria for primary IN transplant physician
If no qualified pediatrician on staff: Physician meeting primary IN transplant physician criteria
for adults can function as primary IN transplant physician for the pediatric program Pediatric gastroenterologist must involved in the care
Provision for Combined Adult/Ped Programs
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
What Members will Need to Do
Centers Performing at Least One Intestine Transplant 2009-2013
(n = 26 “active” out of 41 registered IN programs)
Center N
A 125B 97C 89D 57E 54F 46G 40H 40I 27J 18K 14L 13M 11N 9
Center N
O 6P 6Q 5R 4S 4T 2U 2V 2W 1X 1Y 1Z 1
Total # 675
David C. Mulligan, MD Committee Chair
Name Region # Representative Email
Ann Harper Committee Liaison [email protected]
Questions?
