2011 - 10th Meeting - IHCTAS


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Concurrent Sessions. Session 8: Implementing VCA: Donor and Procurement Issues

14.1 - Development of Donation Best Practices in VCA

Presenter: Jeffrey P., Orlowski, New York, NY, USA
Authors: Jeffrey P. Orlowski

Jeffrey P. Orlowski, Center for Donation and Transplant, New York, NY, USA.

Overview: The practice of VCA transplantation is in Its early development in the United States (US). As a result, best practices associated with VCA donation from an OPO perspective as well as systems for regulation and allocation of VCA donation have yet to be formalized. Nonetheless, based upon limited VCA practice to this point and 40-plus years of developing organ donation best practices. there are some fundamental principles practitioners can use to guide their next steps.

Recommendations: First, it is recommended that all hospitals considering or planning to initiate VCA transplant reach out to the CMS-designated OPO for their geographic location in the earliest stages of developing a clinical VCA transplant program. Items which must be clearly addressed include education of both OPO and transplant center staff on the entire donation process; a clear plan of educating prospective donor hospitals both prior to a donation occurring and WHILE it is occurring; and a complete plan of how to handle the media attention such transplants will attract.

Second, it is recommended that an OPO with a prospective new VCA program reach out to established programs and OPOs serving them to adopt best practices and avoid pitfalls that others have previously experienced. Rather than re-inventing the wheel, new programs should first learn from those with experience to avoid unnecessary issues. Conversely, established programs must freely and collaboratively share their knowledge if VCA is to be successful and undesired media events are to be avoided.

Finally, as an OPO CEO, the speaker calls upon HRSA to designate the task of developing center guidelines, allocation policies, and a US scientific registry (analogous to the SRTR) to the current OPTN contractor. Since the National Organ Transplant Act was passed and implemented in the mid-1980's, much has been learned in establishing a national allocation network for allocation and data collection; there is no need to reinvent the learning process already experienced nor any reason to fall prey to pitfalls previously addressed.

Discussion: Clearly VCA transplantation is a coming field of care. It has tremendous potential for societal benefit but also has tremendous potential for negative publicity if not properly undertaken. Addressing the recommendations above will be a helpful start to moving VCA transplant in the US in a positive direction.

Objectives:

  • Familiarize the learner with AOPO and the role of OPO's in the US with regard to allocation and education.
  • Discuss and provide recommendations to the learner for "must-do" steps to be completed by any OPO or VCA transplant center.
  • Discuss and provide recommendations for appropriate regulatory steps to betaken in the development of VCA transplant in the US.

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