1. Todd Pesavento, M.D. Regional Councillor
Region 10 Meeting
Todd Pesavento, M.D.
Regional Councillor
Welcome to the fall Region 10 meeting. We know you took time out of your schedule to be here and your attendance is appreciated. I would also like to thank Essential Pharmaceuticals, Sanofi Genzyme, and Veloxis Pharmaceuticals for exhibiting at our meeting today.

2. Meeting Agenda Update from OPTN/UNOS leadership
Review and discuss 5 public comment proposals
Your feedback will be shared with the Kidney (2), OPO, Liver, and Pancreas Committees
Updates on committee activities: Thoracic, Kidney, and Liver Committees
Today’s meeting includes
An update from OPTN/UNOS leadership – David Klassen, UNOS Chief Medical Officer is here
Discuss and comment on proposed policies – your feedback will be shared with the sponsoring committees
You will also hear updates from the Thoracic, Kidney, and Liver Committees.

3. Regional Business Summary of spring 2017 regional meeting
Why should you review it?
Committee’s response to our region’s comments
Board’s action on each proposal
Information on implementation date
A summary of the fall regional meeting is located in the booklet at your seat and is posted to Transplant Pro for your review.
The summary provides information about the proposals that we discussed at the spring meeting, and where they stand now. The summary includes each committee’s response to our region’s comments, the Board action taken on each proposal, and information about implementation. Implementation dates are not available for proposals that require computer programming.

4. Spring 2018 Regional Meeting Date
Spring public comment: January 22 - March 23, 2018
proposals will go to the Board for review in June
Mark your calendar! Spring region 10 meeting:
Friday, February 23
The regional meeting cycle runs concurrent with the public comment cycle. The spring 2018 public comment cycle will begin on January 22 and end March 23. The public comment proposals we discuss at the spring regional meeting will be reviewed by the Board in June.
The spring regional meeting will be held on Friday, February 23rd.

5. Region 10 Meeting Attendance
This slide shows our region’s meeting attendance over the last 3 meeting cycles compared to the nation. Region 10 data is in blue (% of OPOs and transplant centers that attend the meeting) and national data is in red. Our goal is to have at least one representative from each OPO, transplant center and histocompatibility lab. If you have suggestions to help engage more members in the meetings, please let me or Shannon know.

6. Region 10 meeting location
Concerns from the region that the meeting location isn’t convenient for all members
No meeting location is convenient for all, but some members travel 4+ hours to attend the meeting in Dayton
We are suggesting a compromise: continue meeting in Dayton once per year (spring), and select a different city for the Fall meeting
Looking at the driving distance, Toledo appears to be a good option

7. Travel analysis of major cities in the region: most convenient options are Toledo and Dayton
Toledo
Dayton
Indianapolis
228 miles (3h, 31m)
116 miles (1h, 52m)
Cincinnati
204 miles (3h, 39m)
67 miles (1h, 6m)
Cleveland
211 miles (3h, 20m)
Columbus
144 miles (2h, 25m))
72 miles (1h, 9m)
150 miles (2 h, 11m)
Detroit
59 miles (59m)
211 miles (3h, 28m)
Grand Rapids
185 miles (2h, 49m)
303 miles (4h, 37m)
Next steps: a ballot will be sent to the voting representatives at the OPOs, transplant centers, and histocompatibility labs.

8. Regional Business As councillor, my role is to:
Chair the regional meetings
Serve as the region’s representative to the Board of Directors
Share the region’s comments on public comment proposals
To best represent the region, I need to hear from you
Welcome members of the Board of Directors
As the regional councillor, I chair the regional meetings and oversee regional operations. Most importantly, I serve as the region’s representative to the Board of Directors. I am the voice of the region at the board meetings, and present the region’s comments on public comment proposals and other OPTN/UNOS matters. In order to do this, I need to hear from you. To that end, speak up today, and feel free to or call me with any issues or concerns.
I would like to welcome the Board members in attendance. If you would, please stand and state your position on the Board.
Board members who might attend (all are registered except Mitch): Gordon Bowen, Danyel Gooch, Mitch Henry, Ken Washburn

9. OPTN/UNOS Committee Nominations
Early September: call for nominations distributed for committee member openings in July 2018
Nominations accepted for all committee openings: regional representatives, at-large members
Regional representatives: additional responsibility of serving as a liaison between the committee and the region
presenting committee’s work at regional meetings
representing the region’s comments at committee meetings
In early September an official call for nominations was sent to the region. However, you can apply for a committee or Board position anytime by visiting the OPTN website and completing a biography form. Committee nomination information is also available on the OPTN and Transplant Pro websites and at the booklet at your table.
Nominations are being accepted for all committee openings, including regional representatives and at-large members. Both positions essentially have the same responsibilities, with regional representatives having the additional responsibility of being the liaison between the committees and the region. Regional representatives present updates on the committee’s work during regional meetings. They are also responsible for representing the region’s comments at committee meetings.

10. OPTN/UNOS Committee Nominations
Interested individuals must submit a bio form online
OPTN website Members tab Get Involved
Bio form includes a section to indicate specific committee and Board interest, including the position(s) you are interested in
New: If you submitted a bio form last Fall and were not appointed to a committee, you will be contacted to confirm your interest
Interested individuals must submit a bio form online to be considered for a committee vacancy. The bio form is located on the OPTN website under the members tab.
The bio form includes a section for individuals to indicate their committee and Board interests. You can also select whether you want to serve as a regional representative and an at-large member. You can select both positions if you are interested.
If you submitted a bio form last Fall and you were not appointed to a committee, you will be contacted to confirm your interest. At that time you can indicate additional committee interests.

11. Committee Nominations: Regional Reps
Deadline to submit bio forms for regional representative vacancies is October 20
Regional Nominating Committees meet in November
Considerations:
Professional experience
Committee needs for subject-specific expertise
Ability to represent regional and national perspectives
Diversity in profession and demographics
Past regional engagement
Geographic balance in region
If you would like to be considered for a regional representative position on a committee, submit your bio form by October 20.
The regional nominating committee reviews all nominations received from the region. The committee will meet in November. The committee selection process is based on an individual’s professional experience, the needs of each committee for subject specific expertise, the ability of the candidate to represent the regional and national perspectives, diversity in profession and demographics, participation and engagement at a regional level, and the desire to have representation from as many areas of the region as possible.
FYI – in case you need it, the Nominating Committee membership includes you, Atsi Yoshida (associate councillor), Tim Taber (immediate past councillor), and 2 additional representatives from each state, for a total of 9.

12. Region 10 Vacancies on Committees (terms begin July 1)
Ethics Committee
Last year, the Board of Directors approved a proposal to increase committee terms to 3 years, with the exception of the MPSC that remains a 2 year term.
Due to this recent change, there are fewer committee openings during this nomination cycle. Region 10 only has one opening in July 2018, on the Ethics Committee.

13. OPTN/UNOS Committee Nominations
To be considered for an at-large position, submit bio form by December 1
OPTN/UNOS President-Elect reviews regional and at-large recommendations
Committee appointments final by March 1. New committee appointees will be contacted and will begin orientation and onboarding process
Committee term begins on July 1, 2018
If you would like to also be considered for an at large member opening, submit your bio form by December 1.
The President Elect of the OPTN and UNOS reviews regional and at-large recommendations and makes final appointments. Candidates who are appointed will be notified by March 1. Committee terms begin July 1, 2018.

14. Regional Meeting Agenda: Non-Discussion
Includes proposals anticipated to be:
non-controversial,
minimal impact on the transplant community, and/or
represent a clerical change to clarify policy or remain current with clinical practice
Region was offered an opportunity to request that a proposal(s) be placed on the discussion agenda
Proposals will be voted on today, but not presented or discussed
Proposals presented and discussed during national webinars
The proposals on the non-discussion (ND) agenda are anticipated to be non-controversial, have minimal impact on the donation and transplantation community, and/or represent a clerical change to clarify the intent of policy or to remain current with clinical practice. The ND agenda is developed to give the regions more time to thoroughly discuss proposals that are controversial and have a larger impact on the community as a whole.
You were provided an opportunity to request that a proposal on the non-discussion agenda be moved to the discussion agenda. We didn’t receive any requests to remove the proposals we will vote on today from the non-discussion agenda.
The proposals on the non-discussion agenda will be voted on today, but they will not be presented or discussed.

15. Non-Discussion Proposals: Vote You have the option to abstain from voting if you haven’t reviewed the proposals
Living Organ Donation by Persons with Certain Fatal Diseases Who Meet the Criteria to Be Living Organ Donors (Ethics Committee)
Review of HLA Tables (2016) (Histocompatibility Committee)
Addressing Approved Transplant Fellowship Training Programs Bylaws (Membership and Professional Standards Committee)
Guidance for Transplant Program Participation in the Transplantation of non-A1/non-A1B (A2/A2B) Donor Kidneys into Blood Group B Candidates (Minority Affairs Committee)
This slide and the next one includes a list of the proposals on the non-discussion agenda that we will vote on today. **Read the title of each proposal** Next slide includes additional proposals

16. Non-Discussion Proposals: Vote You have the option to abstain from voting if you haven’t reviewed the proposals
Guidance on the Benefits of Pancreas After Kidney (PAK) Transplantation (Pancreas Committee)
Revisions to Pediatric Emergency Membership Exception Pathway (Pediatric Committee)
Regional Review Board Guidance for Adult Congenital Heart Disease Exception Requests (Thoracic Committee)
The plan is to take one vote on the 7 items unless anyone is opposed to a specific proposal. If you will vote to oppose a proposal, please raise your hand and we will vote on each proposal separately, or vote on the proposal you don’t support separately.
Note to councillors:
**Please remind the group that they have the option to abstain if they didn’t attend one of the national webinars to hear the proposal presented or haven’t read the proposal online.
If no hands are raised, take one vote on the 7 items: yes, no, abstentions
If hands are raised: vote on each proposal separately – yes, no, abstentions

17. Public Comment Opportunities
Share your comments today
Contact Regional Representatives
List is located in the meeting booklet and on Transplant Pro: select the community tab, and then “regions”
Submit public comment online
OPTN website:
Public comment closes October 2
Sponsoring committee considers feedback in development of final proposal
Board receives all public comment
If you have feedback on any of the public comment proposals, you have a few ways to provide it.
We want to hear your comments today.
You can also contact our region’s representative to the sponsoring committee. A list of our region’s representatives is located in the booklet at your seat and also on the Transplant Pro website.
You can also submit an individual public comment online through the OPTN website.
Regional feedback is important as it is considered by the sponsoring committee when developing final proposals, and public comment proposals are often modified and improved based upon regional feedback.
The Board also receives all public comment responses so that the directors have a sense of the transplant community’s sentiment about a given proposal.

18. Regional Meeting Materials – online!
Today’s presentations are posted on Transplant Pro
Make sure to review the non-discussion proposals and committee updates not presented today
Histo, Living Donor, MPSC, Patient Affairs, Pediatric, Transplant Administrators, VCA
Regional meeting materials are also posted on Transplant Pro
All of the committee presentations and meeting materials are on the Transplant Pro website. A few committees did not present updates at today’s meeting. Please take time to review these presentations posted on the website. Meeting materials for today’s meeting are also posted on Transplant Pro.

19. Regional and National Data

20. Deceased Donation 2016-2017 U.S. Donors Recovered Organs Recovered
Donors Recovered
Organs Recovered
Organs Transplanted
OTPD
July 2015-June 2016
9,514
33,741
29,111
3.06
July 2016-June2017
10,201
35,930
31,081
3.047
% Change
7.2%
6.5%
6.8%
-0.4%
Year in this presentation refers to July-June periods.
Ex: “2017” refers to July June 2017

21. Deceased Donation 2016-2017 Region 10
Donors Recovered
Organs Recovered
Organs Transplanted
OTPD
July 2015-June 2016
810
2,958
2,547
3.144
July 2016-June 2017
935
3,383
2,951
3.156
% Change
15.4%
14.4%
15.9%
0.4%

22. Deceased Donors by Type and Region July 2016-June 2017

23. Deceased Donors by Type 2008-2017 (year: July-June) Region 10

24. Deceased Donor Transplants 2015-2017 (year: July-June) U.S.

25. Deceased Donor Transplants 2015-2017 (year: July-June) Region 10

26. Framing the Day We want feedback from as many attendees as possible
To manage the discussion on each proposal, please limit your comments to new comments, points that haven’t been raised
If the region opposes a proposal, specific feedback and recommended modifications are valuable
To be sure your comments and questions are heard, please use microphones

27. Questions?
Thank you for your attention and I am happy to answer questions.