1. Vascularized Composite Allograft (VCA) Transplantation Committee
Spring 2019

2. Recently Implemented Projects
Proposal
Board Approval
Implementation Date
Guidance to OPOs on Optimizing VCA Authorization & Recovery
Share effective practices for VCA authorization & recovery
June 2018
June 12, 2018
A guidance document to help OPOs optimize VCA authorization and recovery was approved by the OPTN Board in June This resource is available on the OPTN website.

3. 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
Application period target Q2 2019
List Covered Body Parts Pertaining to VCA
Added 8 covered body parts (OPTN Policy 1.2)
Made 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
The Board approved the detailed training and experience requirements for key personnel at VCA transplant programs in June They approved a subsequent proposal clarifying what body parts were considered VCAs in June UNOS staff will be contacting VCA transplant programs as the application process nears. The target for this application period is Q

4. Upcoming Policy Implementations
Proposal
Board Approval
Implementation Date
Aligning VCA Membership Requirements with Requirements for Other Transplant Programs
Achieve greater alignment between VCA membership requirements and solid organ transplant requirements
June 2018
Application period target Q2 2019
One new proposals was approved by the Board in June 2018:
Modifications to the VCA membership requirements for greater alignment with other organ program requirements will be implemented in tandem with membership proposals on the prior slide; the target for this application period is Q

5. Future Projects & Initiatives
Proposal
Status
Understanding VCA Transplant Outcomes
Modify recipient data collection to have better understanding of VCA transplant outcomes
Ongoing discussions
Public comment target – January 2020
Collaboration with AOPO
Increase deceased donors screened for VCA donation
Ongoing through 2019
The VCA Data Subcommittee is having on-going discussions on a proposal to collect wider amounts of information on VCA transplant recipients. The goal of this project is to have a better understanding of VCA functional outcomes to guide future policy-making decisions. A target for public comment on this proposal is January 2020.
AOPO has committed to working with their partner organizations to increase the number of donors screened for possible VCA donation. Committee members are collaborating with AOPO on this initiative.

6. Approved VCA Transplant Programs* as of 1/18/2019
VCA Program Type
Number
Abdominal Wall 15
Head and Neck 17
Upper Limb 19
Other VCA
Genitourinary – Uterus 5
Genitourinary – Penis 2
Genitourinary/Urogenital 3
Lower Limb
Musculoskeletal Composite Graft Segment 1
Total 64
*Representing 28 transplant hospitals
Based on most recent available information provided by members to the OPTN as of January 18, 2019.
Data subject to change based on future data submission or correction.

7. VCA Waiting List and Transplant Numbers by Type as of 1/18/19
VCA Type
Candidates Added to Waiting List, 7/3/2014-1/18/19
Transplants, 7/3/2014-1/18/19
Candidates Waiting as of 1/18/19
Abdominal Wall 7 2
Head & Neck: Craniofacial 11 6 4
Head & Neck: Scalp 1
Upper Limb, Bilateral 12 3
Upper Limb, Unilateral 10
Other: GU - Penis
Other: GU - Uterus 30 17
Total 75 39 24
Based on most recent available information provided by members to the OPTN as of January 18, 2019.
Data subject to change based on future data submission or correction.

8. Questions Linda C. Cendales, M.D. Chair linda.cendales@duke.edu
Bohdan Pomahac, M.D.
Vice Chair
Christopher L. Wholley, M.S.A.
Transplant Community Administrator