1. Srinath Chinnakotla, MD, MCh, MBA Regional Councillor
Region 7 Meeting
Srinath Chinnakotla, MD, MCh, MBA
Regional Councillor
Welcome to the fall Region 7 meeting. We know you took time out of your schedule to be here and your attendance is appreciated. I would also like to thank the exhibitors for being with us today.

2. Meeting Agenda Update from OPTN/UNOS leadership
Regional discussion session
Proposed Changes to the Region 7 Nominating and Selection Process Guidelines
Review and discuss 5 public comment proposals
Your feedback will be shared with the Kidney, Pancreas, OPO, and Liver Committees
Updates on committee activities: Thoracic, Kidney, and Liver Committees
Today’s meeting includes
An update from OPTN/UNOS leadership
A regional discussion session - on proposed changes to the regional guidelines we use to nominate and select the associate councillor for region 7
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 7 meeting: March 9, 2018
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 in Chicago on Friday, March 9, 2018.

5. Region 7 Meeting Attendance
This slide shows our region’s meeting attendance over the last 3 meeting cycles compared to the nation. Region 7 data is in blue (% of OPOs and transplant centers that attend the meeting) and national data is in green. Our goal is to have at least one representative from each OPO, transplant center and histocompatibility lab. If you have suggestions to help improve the meetings, please let me or Melinda Woodbury, our regional administrator know.

6. Regional Business As councillor, my role is to:
Chair the regional meetings
Oversee regional business
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 take the opportunity to introduce the Board members in attendance. When I say your name please stand and state your position on the Board.
BOARD MEMBERS
Yolanda Becker
Liz Schumacher
Kathy Schwab
Mike Ison

7. 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 will be 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.
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.

8. 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.

9. Committee Nominations: Regional Reps
Bio forms for regional representative vacancies are due by October 20
Regional Nominating Committees meet in November
Considerations:
Professional experience
Committee needs for subject-specific expertise
Diversity in profession and demographics
Ability to represent regional and national perspectives
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, diversity in profession and demographics, the ability of the candidate to represent the regional and national perspectives, 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 the current councillor and associate councillor, the immediate past councillor, and the representatives to the OPO, Transplant Administrators, and Transplant Coordinators Committees.

10. 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.

11. Communication Efforts
notices to the region
Posted on the region 7 page on Transplant Pro (Community Regions)
Posted on OPTN and Transplant Pro websites
We are communicating the call for nominations broadly by ing notices to each region and posting the information on the OPTN and Transplant Pro websites.

12. Region 7 Vacancies on Committees (terms begin July 1)
Ethics Committee
There will be one opening on the Ethics Committee with a term beginning July With the exception of the MPSC/Associate Councillor position, all positions are 3 year terms.
Note about Histo Committee: in case it comes up, an election is held for this position, per the OPTN bylaws.

13. 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.

14. National Webinars
Recordings posted on OPTN (Governance Public Comment) and Transplant Pro (Community Regions) websites
Webinars held in August: non-discussion agenda items
Webinars: discussion agenda items
OPO and Liver Committees proposals on Aug 15
Kidney and Pancreas Committees proposals: September 12, 2:00 pm EDT
Registration link on OPTN and Transplant Pro websites
Two webinars were held in August to present summaries of the proposals, guidance documents, and white paper on the non-discussion agenda. Members were given an opportunity to ask questions and provide feedback on the webinars.
Recordings of the non-discussion webinars are posted on the OPTN and Transplant Pro websites.
Two webinars were scheduled to review and discuss the proposals on the discussion agenda. The first was held on August 15 and the OPO and Liver Committees proposals were discussed. A second webinar will be held on September 12 to review the Kidney and Pancreas Committees proposals. The registration link is posted on the OPTN and Transplant Pro websites.

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**

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:
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 will be 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
2016
9,514
33,741
29,111
3.06
2017
10,201
35,930
31,081
3.047
% Change
7.2%
6.5%
6.8%
-0.4%

21. Deceased Donors by Type and Region 2017
A relatively small percentage of donors recovered in Region 3 are from DCD, while at least 20% of donors in Regions 1 and 6 are DCD donors. Regions 2, 3, 7, and 9 have the greatest percentages of ECDs with over 24%

22. Deceased Donation 2016-2017 Region 7
Donors Recovered
Organs Recovered
Organs Transplanted
OTPD
2016
771
2,773
2,350
3.048
2017
805
2,926
2,513
3.122
% Change
4.4%
5.5%
6.9%
2.4%

23. Deceased Donors by Type 2008-2017 Region 7
-14%

24. Deceased Donor Transplants 2015-2017 U.S.

25. Deceased Donor Transplants 2015-2017 Region 7

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 floor microphones

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