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

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

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. UW Health OPO Donation Service Area UWHC OPO 105 hospitals 70 counties 3.2 million population

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 486.324 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 40-50 people

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: (i)Number of organs transplanted per standard criteria donor (ii)Number of organs transplanted per expanded criteria donor (iii)Number of organs used for research per donor UW OPO* U.S. 3.66 3.64 2.45 1.81.23? *CY2008

10. Conversion Rates 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

13. Import & Export Organs Difference = 16 Difference = 18 Difference = 60 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