Vascularized Composite Allograft (VCA) Transplantation Committee Fall 2017

Upcoming Policy Implementations Proposal Board Approval Implementation Date Membership Requirements for VCA Transplant Programs Established minimum training and experience requirements for key personnel June 2015 Forms under review by U.S. Office of Management and Budget, Date TBD List Covered Body Parts Pertaining to VCA Added the 8 covered body parts (OPTN Policy 1.2) Make training and experience requirements for primary transplant surgeons of head, neck and upper limb transplant programs consistent Non-substantive changes to Bylaws, Appendix J for style, consistency, and clarity June 2016

Future Project Ideas Proposal Status Guidance to OPOs on Optimizing VCA Authorization & Recovery Developing guidance document and educational resource In progress Aligning VCA Membership Requirements with Requirements for Other Transplant Programs Need greater alignment of membership requirements in OPTN Bylaws Appendix J of VCA and solid organ transplant programs. In Q1 2016, the VCA Committee surveyed OPOs in the U.S. to identify barriers to VCA authorization and recovery. This survey helped identify areas for future guidance to increase VCA donation. The Committee is developing a guidance document and educational resource for OPOs to increase the number of VCA donors. The anticipated date for the Board of Directors to consider this guidance is June 2018. The Committee is in early discussions to bring greater alignment of the VCA membership requirements in OPTN Bylaws, Appendix J with those for solid organ transplant programs. Chief among these amendments is the addition of a continuing education pathway for key personnel who are ineligible for U.S. board certification. Such pathways exists for key personnel at heart, lung, liver, kidney, and pancreas transplant programs. The anticipated date for consideration by the Board of Directors is June 2018.

Approved VCA Transplant Programs* as of 7/7/2017 A list of all the approved programs are on the OPTN site. * Representing 27 unique transplant centers Based on most recent available information provided by members to the OPTN as of July 7, 2017. Data subject to change based on future data submission or correction.

VCA Waiting List and Transplant Numbers by Type as of 7/7/17 VCA Type Candidates Added to Waiting List, 7/3/2014-7/7/17 Transplants, 7/3/2014-7/7/17 Candidates Waiting as of 7/7/17 Abdominal Wall 4 1 Head & Neck: Craniofacial 7 5 Head & Neck: Scalp 2 Upper Limb, Bilateral 10 3 Upper Limb, Unilateral 9 Other: GU - Penile Other: GU - Uterus Total 45 24 14 Based on most recent available information provided by members to the OPTN as of July 7, 2017. Data subject to change based on future data submission or correction.

Questions L. Scott Levin, M.D., FACS Chair, VCA Transplantation Committee scott.levin@uphs.upenn.edu Christopher L. Wholley, M.S.A. Policy Analyst christopher.wholley@unos.org