Posts Tagged ‘united network for organ sharing’

Proposed Redistricting for Liver Transplant Sharing Negatively Impacts Georgia and Southeast

liver-250x250A proposed redistricting policy in the regional structure for liver transplant distribution may have a negative impact on the state of Georgia and the region.

Currently, the demand for liver transplants exceeds the supply of liver donations nationwide, and many patients with liver disease will die while on the waitlist to have this life-saving surgery. To decrease the disparity in wait times for liver transplantation in the U.S., the United Network for Organ Sharing (UNOS), with the support of the Scientific Registry of Transplant Recipients (SRTR), is proposing to change the current liver allocation distribution. This plan proposes to share donor organs more broadly in an attempt to reduce geographic disparities.

But experts at the Emory Transplant Center say the proposed changes would:

  • Drive up costs.
  • Decrease survival rates.
  • Lower the quality of donated organs because of a longer travel time to the intended recipient.
  • Extend the recovery period for the patient.
  • Exacerbate disparities in health care suffered by minority and rural communities.

The Southeast already faces substantial health-related disparities, including less insured patients, fewer available doctors and higher rates of liver disease overall.

The proposed redistricting will take organs from the South, which already has multiple barriers to liver disease care for minority, low-income, and rural patients, and send them to the Northeast, which has a much higher rate of listing liver disease patients.

Currently, the U.S. is divided into 11 regions. Georgia is in Region 3 along with Alabama, Arkansas, Florida, Louisiana, Mississippi and Puerto Rico. Within Region 3, livers are shared across state lines for patients with a MELD (Model of End Stage Liver Disease) score greater than or equal to 35. A MELD score is used to determine a patient’s place on the liver transplant waiting list. A higher MELD score means a higher mortality rate. Because some patients’ disease is poorly reflected by MELD alone, they may be granted an “exception score” to make them competitive for organs. Certain regions, however, grant these exceptions more freely, so that patients’ average scores at transplant may differ greatly between regions.

The new proposal would change the 11 regions to eight districts, with Georgia in District 1. The new district would expand up the Atlantic Coastline and include South Carolina, North Carolina, Virginia, Washington, DC, Maryland, Delaware, New Jersey, New York, Connecticut, Rhode Island, Massachusetts, New Hampshire, Maine, as well as Puerto Rico. Within this district, livers would be shared across state lines for patients with MELD scores equal to or greater than 29.

We feel the new proposal will have a negative impact on patients waiting for liver transplants in Georgia and across the Southeast. Emory prides itself on our commitment to our patients. In transplant, this commitment includes a dedication to maintaining availability of donor livers for patients most in need. For more information about liver transplants in Georgia and the Southeast and what you can do to help, visit the Collaboration for Donation Fairness website.

Emory Transplant Center Ranks 7th Nationally

The Emory Transplant Center ranks 7th among transplant programs across the nation based on adult transplant volumes. In calendar year 2014, we performed 441 adult transplants that placed us 7th overall, tied with Barnes-Jewish Hospital. Our top 10 ranking puts us among good company.

 

 

 

 

 

And with the recent release of the latest Scientific Registry of Transplant Recipients (SRTR) data, it revealed that all Emory solid organ programs, when risk-adjusted, are similar to if not statistically different from the national data and meet expectations for performance set by the United Network for Organ Sharing (UNOS) Membership Professional Standards Committee (MPSC).

The new SRTR center-specific data included the following one-year graft and patient survival rates for our patients:

Heart:
Patient survival rate: 90.4% (actual) vs. 90.75% (expected)
Graft survival rate: 80.95% (actual) vs. 84.3% (expected)

Kidney:
Patient survival: 98.1% (actual) vs. 97.4% (expected)
Graft survival: 95% (actual) vs. 94.4% (expected)

Kidney/Pancreas:
Patient survival: 100% (actual) vs. 97.9% (expected)
Graft survival: 100% (actual) vs. 95.8% (expected)

Liver:
Patient survival: 93.8% (actual) vs. 91.6% (expected)
Graft survival: 91.7% (actual) vs. 89.2% (expected)

Lung:
Patient survival: 84.7% (actual) vs. 87.1% (expected)
Graft survival: 84.5% (actual) vs. 90% (expected)

*adults; cohort 1/1/12 – 6/30/14 (deaths and re-transplants were counted as graft failures)

Also of note, the Emory Kidney Transplant program’s three-year graft survival remains statistically greater than expected (p < 0.05) with outcomes of 89.48% (actual) vs. 86.29% (expected).

Our experience coupled with continued excellent outcomes in all solid organ programs make the Emory Transplant Center a leading transplant destination in the Southeast and the nation, serving patients in Georgia and bordering states. We are proud to be your transplant center.

Site Visits Show Emory Transplant Center’s Patients are in Excellent Hands

GoldSeal_4colorSuccess in a transplant center is measured by many standards — high patient and graft survival rates, satisfied patients and quality care, to name a few — but Emory really does stand out
when national regulatory agencies come for required site visits. Three agencies, the United Network for Organ Sharing (UNOS), the Joint Commission (TJC) and the Centers of Medicare & Medicaid Services (CMS), visited the Emory Transplant Center (ETC) this year. Their hard work was evident in the positive comments we received from the surveyors.

For the first time in ETC’s history, the Joint Commission surveyed hospital-based outpatient clinics during their site visit in July – this included both the ETC’s Outpatient Transplant Clinics at Emory Saint Joseph’s Hospital and the Emory Clinic.

“The surveyor was happy with the nurses’ notes on a sample procedure stating, ‘This is the only chart I have ever read that has all the information I was looking for when a patient is being discharged from the clinic after a procedure.’ She was impressed.”, reports Joji Taganajan, nurse manager.

Our CMS re-certification survey was conducted the last week of April. The reviewers surveyed Emory’s heart, kidney, liver, lung, and pancreas programs, examining medical records for documentation of the multiple CMS conditions of participation, reviewing ETC policies, practices, and quality assessment and performance improvement (QAPI) programs. All five transplant programs were re-certified.

Additional good news came to the programs on July 13 in the form of letters from the UNOS Membership and Professional Standards Committee (MPSC). The MPSC reported results of its routine on-site review of the programs, conducted by the UNOS staff the week of January 26. The purpose of the survey, which is conducted every three years, is to review and analyze transplant program compliance with UNOS/OPTN (Organ Procurement and Transplant Network) policies. All ETC programs passed with scores between 92 and 100.

A heartfelt thank you goes out to all our transplant staff, faculty and leadership who provide our patients and families excellent clinical care on a daily basis, while achieving impressive quality outcomes and meeting the multiple federal regulatory requirements for transplant centers.

Emory Transplant Center Executive Director Elected to National Council by Peers

Dr. Thomas C. Pearson

Dr. Thomas C. Pearson

Thomas Pearson, MD, DPhil, executive director of the Emory Transplant Center, has been elected by organ donation professionals as incoming associate councillor of the Organ Procurement and Transplant Network and United Network for Organ Sharing (OPTN/UNOS) Region 3. Each of the 11 OPTN/UNOS regions has an associate councillor who serves as the regional representative to its national Membership and Professional Standards Committee. This committee oversees transplant community membership, policy and regulatory compliance and makes recommendations to the board regarding policy violations.

“Since 1991, Tom has been a valued friend and colleague at Emory and an esteemed transplant surgeon, bench and clinical researcher,” says Christian Larsen, MD, DPhil, dean of Emory University School of Medicine, former executive director of the Emory Transplant Center and a current kidney transplant surgeon. “But he also is internationally respected as a transplant immunologist, educator and transplant advocate, establishing many protocols in place today. He is perfectly suited to this role at OPTN/UNOS Region 3.”

Pearson, who is surgical director of the kidney transplant program at Emory and the Livingston Professor of Surgery, joined the Emory faculty in 1991. Together, with long time collaborator Larsen, they played a pivotal role in developing a new class of immunosuppressive drugs to replace the cyclosporine class of drugs and their major side effects and toxicities. The FDA approved the co-stimulation blocker called belatacept in June 2011 for kidney transplant recipients. This was the first time a new class of drug had been approved for transplant since the 1990s.

After Pearson’s term as associate councillor ends in 2016, he will assume the role of councillor for an additional two-year term of service (2016-2018), representing Region 3 on the OPTN/UNOS board of directors. Pearson also serves as medical director of LifeLink of Georgia, is a member of the Board of Governors for the LifeLink Foundation and is a board member of the American Society of Transplantation.