Randall S. Sung, MD
Professor of Surgery, Surgical Director, Kidney & Pancreas Transplantation
University of Michigan Medical Center

Commitments & Progress:
Commit to increasing living donation in our program through increasing education at all levels and identification of opportunities.
Progress: We have worked to increased living donation on a number of fronts. Among them include:

• Creation of a 2-3 hour program, “Facts and Myths about Living Donation”, for transplant candidates and their potential donors. Speakers include representation from the entire multidisciplinary team, and previous living donors and living donor recipients. Feedback has been overwhelmingly positive, and we are currently doing this three times per year.
• Process improvement project in the living donor office focused on efficiency of evaluation, scheduling, and communication between donor and recipient coordinators.
• Kidney transplant program app with a section of living donation at the top of the menu.
• Developing living donor champion education program.
• All cleared donors and recipients are approached about compatible paired donation.
• Recent analysis of outcomes of living donor evaluations to determine why donors or declined or otherwise do not donate.
• Creation of a monthly living donor dashboard with process and outcome metrics – reviewed at leadership and QI meetings.
• Several on the living donor team are working on enhancing our donor appreciation activities – additional video follow-up visits, anniversary cards, appreciation events, etc.

We are still awaiting impact on living donor transplants. Our evaluation numbers are slightly increased – we view this as a positive in light of a decrease in recipient transplant evaluations since implementation of a pre-evaluation triage function on the recipient side.

Commit to increasing analysis of organ turndown to create more uniform organ acceptance parameters within our program.
Progress: For organ turndown review, the potential function of the OPO in coordinating this, as previously planned, fell through with a transition to new OPO leadership. However, we have secured additional QI resources for the transplant program, and one of the priorities for this group is to develop an organ acceptance review process. We should start planning this after the New Year.

Jon Snyder, PhD
Director of Transplant Epidemiology
Chronic Disease Research Group

Commitments & Progress:
Provide the transplant programs and OPOs metrics on offer acceptance/decline patterns at programs, starting with kidney and moving on to other organs. Metrics will include subgroup analyses for specific “hard to place” organs.
Progress: In 2017, the SRTR launched offer acceptance reports for all kidney, heart, lung, and liver programs. An additional report detailing how all programs stack up against each other for acceptance of organs and “hard to place” organs is now provided.

Work with the community and the OPTN’s Data Advisory Committee to enhance the UNet data collection system to improve risk prediction.
Progress: In 2017, the SRTR completed a project working with the Mayo Clinic’s Evidence Practice Center to conduct a systematic literature review of published studies detailing variables that aid in risk prediction pre- and post-transplant that are not currently collected in the OPTN data system. That report has been provided to the Data Advisory Committee of the OPTN for consideration.

Sherry Tenge, RN, BSN
Clinical Transplant Programs Manager
SSM Health Saint Louis University Hospital

Commitment & Progress:
Commit to teach my coordinators not to present biased information first when reviewing organ offers with on-call surgeon. i.e. don’t start with “we are sequence #300 or #3 local centers have coded out” etc. This will encourage evidenced based decision-making vs biased decision-making.

Progress: Since The National Critical Issues Forum “Disrupting the Status Quo” meeting in October, 2016, I have met with my seasoned coordinators on multiple occasions coaching them on how to present an offer that is un-biased and is instead fact-based to the on-call surgeon. At our center, the coordinators take donor net call and are responsible for presenting all offers to surgeons.
I also have 3 new coordinators that have starting training and I have spent an immense amount effort in training them from the beginning on how to present an organ offer to a surgeon in an un-biased way.

Since October, we have seen a data based decrease in percentage of local offer declinations that were transplanted elsewhere.

Our coordinators and surgeons are committed to organ utilization and make every effort to responsibly do a transplant when an organ is available.