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Liver & Intestinal Organ Transplantation Committee

Liver & Intestinal Organ Transplantation Committee. Fall 2014. Recent Public Comment Proposals. Cap HCC at 34 Intent: To give candidates with a calculated MELD/PELD of 35 and higher a better opportunity to receive regional offers under the Share 35 policy Public comment was favorable

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Liver & Intestinal Organ Transplantation Committee

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  1. Liver & Intestinal Organ Transplantation Committee Fall 2014

  2. Recent Public Comment Proposals Cap HCC at 34 Intent: To give candidates with a calculated MELD/PELD of 35 and higher a better opportunity to receive regional offers under the Share 35 policy • Public comment was favorable • No substantial post public comment changes • Board review - November 2014

  3. Recent Public Comment Proposals Delay HCC Exception Score Assignment Intent: Reduce the disparity in transplant and drop-out rates for candidates with and without HCC exceptions • No substantial post public comment changes • Board review – November 2014

  4. Recent Public Comment Proposals Criteria for Intestine Surgeons and Physicians • Public comment was mixed • Committee responding to concerns and considering increasing timeframe for experience • Spring 2015 Public Comment

  5. Policy Implementation Dates Adding Serum Sodium to the MELD Score • Board approved June 2014 with the following amendment: • Applies only to candidates with a MELD score greater than 11 • Implementation upon programming, TBD • 7 day “grace period” for transition

  6. Ongoing Committee Initiatives Redesigning Liver Distribution • Concept Document released in June, accompanying questionnaire responses collected through July • 692 Responses • Public Forum held in Chicago on 09/16/2014 • 264 people in attendance, 282 online participants No policy proposal at this time, any developed will require public comment

  7. Ongoing Committee Initiatives Redesigning Liver Distribution Ad Hoc Subcommittees : • Metrics of disparity • Finance • Transportation and logistics Parallel efforts: • Increasing liver donation and utilization

  8. Ongoing Committee Initiatives • National Review Board • Construct under consideration: • 10 Representatives from each region, 2-3 year terms, 2 term limit • Standard guidelines reviewed and approved by the Liver and Intestinal Committee for approving exception cases will be developed for the NRB • Spring 2015 Public Comment

  9. Questions? • David C. Mulligan, MD Committee Chair david.mulligan@yale.edu • Regional Rep name (RA will complete) Region X Representative email address • Ashley Archer-Hayes Committee Liaison ashley.archer-hayes@unos.org

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