OPO Staff Appreciation Days
Without the tireless efforts of the staff at the organ procurement organizations, patients would not receive the life-saving transplants they need. As such the NYCTC joined with the New York State (NYS) transplant programs to host events thanking them for their hard work and dedication. In March 2011, each program hosted a half-day event to recognize OPO staff and their contributions to the transplant process. The events included educational opportunities and a chance to make connections with transplant center staff with whom they had frequent contact.
Heart Allocation for Sensitized Patients
Transplant programs in NY are sharing their sensitized patient protocols in an unprecedented effort to ensure some of the sickest patients in NY receive heart transplants. The NYCTC Policy and Operations Committee (POC) looked at issues relating to out-of-sequence heart allocation for sensitized patients. The Committee reviewed UNOS policy (184.108.40.206) which revealed a provision allowing the creation a region-wide policy to help formalize the process. NYCTC staff worked with the New England Organ Bank (NEOB) to obtain a copy of the New England Center for Heart Transplantation’s (NECHT) policy. In discussing the possibility of adapting the protocol for use in Region 9, the members shared their desensitization protocols as well as data from their centers on the number of cases, and determined that a region-wide policy was not warranted at this time.
Retrospective Data Review
Are we using all available donor lungs? Are there changes we can make to improve access to hearts for NYers? NYCTC members and NYS OPOs are sharing retrospective data to ensure the best use of all available organs, maximizing opportunities for their patients. The members and OPOs agreed to participate in a retrospective data collection project, reviewing 2010 and 2011 data. The goal of the project is to study patterns of organ acceptance and turndowns in NYS. Some key considerations were to use a data-driven review process which would allow us to test whether the centers are following best practices, to identify opportunities to increase local organ recovery, and to determine if NY centers could be more aggressive in their acceptance practices or if they are being appropriately selective.
Quarterly Data Review
Members and OPOs share data on a quarterly basis. Data collected from the centers is listed by those patients on ventricular assist devices (VADs) and those not on VADs. Data which includes the number of deaths on the waiting list, and the numbers of adult and pediatric heart transplants performed (heart-only and heart-multi-organ) is further broken down to show status on the waiting list. Additional data points report imported organs vs. locally recovered, as well as re-transplants. The 4 NYS OPOs provide data that includes detailed information on the allocation of the local organs consented, noting turndowns, discards and organs used for research. Data collected will serve to enhance the quality of heart and lung transplant services in NYS.
UNOS Data Review
Data requests were prepared and submitted to UNOS requesting heart and lung data from 2004-2011. The heart data was received from UNOS and presented to the POC at their September meeting. This data showed that overall deaths on the waiting list have decreased from 44 deaths in 2004 to 21 deaths in 2006. Since then, the number has increased each year to 34 in 2010. The data also showed that while NY centers have received more heart offers since changes in the allocation system were implemented in 2006, the number of transplants being done has not increased.
Cardiologist Call Schedule
At the request of the OPOs, each heart program submitted personal cell phone and other relevant contact information to be included in a call rotation of cardiologists whom the OPOs can reach out to, prior to organ placement, for real time consults in donor cases, particularly to help with requesting tests and/or procedures when working with donor hospital intensivists. In December 2011, the NYCTC Board of Directors formally approved the call schedule and distributed it to the NYS OPOs.