1. Pediatric Transplantation Committee
Spring 2019

2. Implementation Status
Implemented Projects
Project
Summary
Implementation Status
Guidance on Pediatric Recipient Transition & Transfer
Inconsistent transfer practices for pediatric transplant recipients to adult programs for post-transplant care
Project shares effective practices for pediatric recipient transition and transfer
Implemented Dec. 4, 2018
(OPTN website: resources>>guidance>>other)
The Pediatric Committee developed guidance for transplant programs on effective practices for transition and transfer of a recipient to an adult transplant program. This guidance was by approved by the Board is December This guidance is available on the OPTN website.

3. Board Approved Projects
Summary
Pediatric Transplantation Training & Experience Requirements
Established requirements for key personnel at pediatric heart, liver, and kidney transplant programs
comment/establish-pediatric-training-and-experience/
(OPTN>>Governance>>Public Notices)
Revise Pediatric Emergency Membership Exception
Outlines requirements for an adult heart or liver programs to register a candidate less than 18 years old.
The Board passed the pediatric transplantation training and experience requirements at the December 2015 Board meeting. Members performing pediatric transplants should carefully consider the requirements against their case experience to ensure they meet or exceed the minimum qualifications. An online tool kit is available on the OPTN website. This tool kit includes a “clean” copy of the requirements with the strikeouts and underlines removed.
In December 2017, the Board approved amendments to the Pediatric Emergency Membership exceptions for heart and liver transplant programs. These exceptions outline when an adult heart or liver transplant program can register a candidate less than 18 years old.
Both of these proposals will be implemented at the same time. The next slide goes into more detail on the tentative timeline.

4. Upcoming Bylaw Implementation: Pediatric Transplant Components - Board Approved 12/2015
Notice
Late Spring 2019
Applications
Summer 2019
Staff & MPSC Review
months
Board Approval
6/2020 – 12/2020
Tentative implementation plan:
Late Spring 2019 – 30 day notice
Summer 2019 – 90 day application period begins
Summer 2019 to Summer 2020 or Fall 2020 – Staff & MPSC Review of applications
Board approval June 2020 or December 2020 – Board Approval
Dependencies:
U.S. Office of Management and Budget (OMB) approval of revised applications
We are providing information on the TENTATIVE plan to implement the pediatric transplant component membership requirements in order to give transplant programs an opportunity to prepare and make sure that the proposed primary pediatric transplant surgeons and physicians can meet the new membership requirements.
The applications for pediatric transplant components will be sent out to members no sooner than Summer All programs that have had a pediatric candidate on their waiting list in the last 5 years will receive an application.
Programs will have 90 days to complete and submit the applications.
We expect a large amount of applications and the MPSC has to review and decide whether to recommend or not recommend approval each application. We estimate the pediatric transplant component membership bylaws will be implemented upon Board approval in mid to late 2020.
This timeline is subject to OMB approval of the revised applications.
If you intend to apply for a pediatric component, you do not need to wait until the application period to start gathering documentation of your experience to satisfy the requirements. Our recommendation is you carefully review the requirements and start gathering information soon. If there is a gap between your experience and the requirements, please consider making a plan to close this gap

5. Pediatric Transplant Components: What members need to know to prepare
Kidney, liver and heart:
Primary pediatric transplant surgeon must
Meet all requirements for primary transplant surgeon
Demonstrate current working knowledge and experience in pediatric transplant
Primary pediatric transplant physician must
Meet all requirements for primary transplant physician
Meet requirements of one of the pediatric training or experience pathways
For pediatric kidney, liver, or heart components:
the primary pediatric transplant surgeon must
Meet all of the requirements for the primary transplant surgeon for that program and
Demonstrate current working knowledge and experience in pediatric transplant.
The primary pediatric transplant physician must
meet all of the requirements for the primary transplant physician and
meet all requirements of one of the pediatric training or experience pathways in the primary transplant physician bylaw requirements for that program.

6. Pediatric Transplant Components: What members need to know to prepare
Lung and pancreas:
Primary pediatric transplant surgeon or transplant physician for pediatric components must meet all requirements of respective requirements for the program
There are no “pediatric specific requirements” for key personnel pediatric lung and pancreas components:
the primary pediatric transplant surgeon and primary pediatric transplant physician must meet all requirements to serve as the primary transplant surgeon or physician for that program.

7. Want additional information?
Contact the UNOS Membership Analyst for your region at , or by
Regions 1, 4, 5, Tierra Yuille
Regions 2, 3, Christi Manner
Regions 6, 7, 9, Nadine Drumn
Tool kit for members is available on the OPTN website
training-and-experience/ (OPTN>>Governance>>Public Notices)
UNOSConnect learning module – course QLT-117
Future updates (web-based, regional meetings, transplant society e- newsletters, social media)
If you have questions or need additional information, please contact the membership analyst for your region.
As I mentioned earlier, a tool kit is available on the OPTN website.
There is also a learning module in UNOSConnect that covers this material.
Future updates will be shared on the OPTN website, TransplantPro, at regional meetings, with the transplant societies, and on social media.

8. Ongoing collaboration
Liver and Intestine Committee
Replace DSA/Region
Board Approved
Kidney Committee
Public comment – concept paper
Thoracic Committee
Public comment
Board consideration pending
Ethics Committee
White Paper on Multi-organ Transplantation
Public Comment
The Committee has been very active in the last several months:
We formed Task Force groups to participate with other organ-specific committees as they developed proposals to address policy issues pertaining to organ distribution. This included pediatric specialists collaborating with the:
Liver Committee on their recent proposal to replace the use of “DSAs” and “regions” in liver distribution approved by the Board in December 2018.
Kidney and Thoracic Committees to replace the use of “DSAs” or “regions” in kidney or heart distribution. The heart allocation proposal and kidney and pancreas concept paper are out for public comment now.
We are also collaborating with the Ethics Committee on a white paper addressing multi-organ transplantation. This is important paper as organs from pediatric deceased donors are often used in adult candidates in need of multi-organ transplants.
We are actively discussing future initiatives and welcome input from our transplant colleagues in the region.

9. Questions?