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Pediatric Transplantation Committee Fall 2013 Update: Ongoing Initiatives and Training Proposals

The Pediatric Transplantation Committee's Fall 2013 update highlights ongoing initiatives focused on enhancing pediatric kidney transplantation. The committee is monitoring the impact of the Kidneys Allocation System (KAS) on highly sensitized pediatric candidates and advocating for Bylaws changes to require specific pediatric transplant experience. Proposed criteria would ensure that transplant programs establish qualified pediatric components for doctors involved in caring for patients under 18, promoting effective training and experience in pediatric organ transplantation.

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Pediatric Transplantation Committee Fall 2013 Update: Ongoing Initiatives and Training Proposals

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  1. Pediatric Transplantation Committee Fall 2013 Update

  2. Ongoing Committee Initiatives • Kidney Working Group • Committee-sponsored variance for highly-sensitized pediatric kidney candidates • Project is tabled • We’ll explicitly monitor KAS impact on highly-sensitized pediatric kidney candidates

  3. Ongoing Committee Initiatives • Pediatric Transplant Training & Experience • Problem: OPTN Bylaws do not require pediatric transplant experience • Recommending Bylaws changes to MPSC for public comment proposal

  4. Pediatric Training and Experience Considerations in the Bylaws - Background • Pediatric Committee began discussions spring 2010 • Prior MPSC annual goal: “Develop qualification criteria for Pediatric Organ Transplant Program approval in conjunction with the Pediatric and organ-specific committees.” • June 2012 – OPTN Strategic Plan • “Develop separate program requirements for pediatric programs”

  5. Pediatric Training and Experience Considerations in the Bylaws • Memo drafted summarizing committee’s discussions and potential solutions • Distributed to AST, ASTS, ISHLT, and each OPTN/UNOS organ-specific committee

  6. Training and Experience Considerations in the Bylaws – Pediatric Committee Recommendations • Establish a “pediatric component” for each and every transplant program intending to transplant patients younger than 18 years of age • “Pediatric component” approval will only entail recognizing qualified individuals to be the “Pediatric Primary Surgeon” and “Pediatric Primary Physician” for each program

  7. “Pediatric Kidney Component” Qualifying Criteria

  8. “Pediatric Liver Component” Qualifying Criteria

  9. “Pediatric Heart Component” Qualifying Criteria

  10. “Pediatric Lung Component” Qualifying Criteria

  11. Pediatric Training and Experience Considerations in the Bylaws – Additional Considerations • Similar to the current Bylaws pathways, these pediatric-specific requirements would be expected of the clinician over 2-5 years • Alternative pathway for individuals who do not meet all of the pediatric-specific requirements, yet very experienced • One individual could fill both, for example, the primary surgeon and the pediatric primary surgeon roles, but it doesn’t need to be the same person.

  12. Questions? • Heung Bae Kim, M.D.,Committee Chairheung.kim@childrens.harvard.edu • Region # Representativename@email • Chad Waller, Committee Liaisonchad.waller@unos.org

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