1. UW Hospital and Clinics Organ Procurement Organization (OPO)
Tony D’Alessandro, MD
Medical Director, UWHC OPO
November 4, 2009

2. What is an OPO?
58 Federally Designated Organ Procurement Organizations (OPOs) in the United States
Must be nonprofit organizations--
In Wisconsin:
UW Health Organ Procurement Organization (“OPO”)
Wisconsin Donor Network (Milwaukee)
Lifesource ( Minnesota)
Regulated by the Centers for Medicare & Medicaid Services (CMS) and United Network for Organ Sharing (UNOS)
Accredited by the Association of Organ Procurement Organizations (AOPO)
Audited by the Food and Drug Administration (FDA), Tissue Banks (4) and Lions Eye Bank; Participate in The Joint Commission surveys
There are 58 OPOs with 8 hospital-owned OPOs such as our’s, and 50 independently-owned OPOs. The Wisconsin Donor Network was previously owned by Froedtert, but is in the process of becoming an independent OPO, reducing the hospital-owned number to 7.

3. Role of an OPO Coordinate the organ donation process
Donor management, organ allocation, transportation, surgical recovery team(s), etc.
86% of organs recovered transplanted at UWHC
Hospital development
Generate referrals from donor hospitals, educate and train healthcare professionals, monthly death chart reviews, etc.
Public education on organ donation awareness
Donor family follow-up and donor family/recipient correspondence
Data reporting & regulatory compliance
Coordinates services with tissue and eye banks
The responsibilities of an OPO are identified by CMS and UNOS and include. . .
Data reporting and regulatory compliance are mandatory and include requirements such as performing chart reviews in 20+ hospitals monthly throughout the region on all patient deaths.

4. Governing Body
UWHC Authority Board is the governing body of the UWHC OPO with full legal authority & responsibility for management and provision of all OPO services:
Appoints individual responsible for day-to-day operations
Delegates authority to review performance, fiscal operations, oversee policies & procedures, and the Quality Assessment and Performance Plan

5. The UW OPO is located in Research Park and has more than 30 employees.
UW Health OPO Donation Service Area
UWHC OPO 105 hospitals 70 counties 3.2 million population
The UW Health Donor Service Area (DSA) is designated by the federal government. This area is shown in red and the light blue. The light blue counties are shared counties with other OPOs. There are 105 hospitals in 70 counties that include 3.2 million people that UWHC is responsible for providing service to.
The UW OPO is located in Research Park and has more than 30 employees.

6. Program Highlights
Twelve Donor hospitals received the 2009 U.S. Dept. of Health & Human Services (HHS) Medal of Honor
HHS Medal of Honor warded for a combination of achieving the national goals for conversion rate, yield and DCD donors.
OPO received 2 awards this year for conversion rate and Donation after Cardiac Death (DCD) donors

7. Centers for Medicare/Medicaid (CMS) OPO Conditions of Participation
Updated CMS regulations effective 7/30/06 include standards for:
Certification and Designation
Re-certification and De-certification
Outcome Requirements
Process Performance Measures
Condition: Administration and Governing Body
Requires Advisory Board and Governing Body
UWHC OPO must meet CMS Conditions of Participation to remain operational

8. Statistics Over 103,000 people waiting for a transplant in the U.S.
Over 1,400 patients in Wisconsin
One person added to the list every 17 min or 3,000 patients each month
18 people nationwide die every day waiting
One donor can potentially donate up to 8 solid organs and help up to people
The main barrier to organ transplantation is organ availability which is why donor awareness education is so important

9. CMS Outcome Measurements
Donation or Conversion Rate (eligible donors/eligible deaths)
Cannot be 1.5 standard deviation below national mean (Next slide)
Observed Rate
Cannot be significantly lower than the Expected Rate (not yet available)
Two out of the 3 below cannot be lower than one (1) standard deviation from national mean:
Need to define donor types – SCD, ECD and DCD
UW OPO* U.S.
.23 ?
*CY2008
Number of organs transplanted per standard criteria donor
Number of organs transplanted per expanded criteria donor
Number of organs used for research per donor

10. Conversion Rates National Average 62%
Conversion Rate: (Eligible Donors/Eligible Deaths) Adjusted Conversion Rate: (Eligible Donors + Other Donors/Eligible Deaths + Other Donors)
National Average
62%

11. Deceased Donor Activity
Record

12. UW Health OPO Donor Referrals
Define Donor Referrals

13. Import & Export Organs
Difference = 16
Difference = 18
Difference = 60
Define imports and exports; increased workload for these
Difference = 78

14. 2010 Upcoming Events First unannounced CMS survey
Establishment of Wisconsin statewide donor registry
Co-host of U.S. Transplant Games to be held in Madison on July 30-August 4, 2010