UNOS Region 5 Collaborative Greg Quinn Care Dx

UNOS Region 5 Collaborative Greg Quinn - Care. Dx August 21, 2019 1 Maxine Moir Kidney Transplant Recipient

Madelyn the Miracle The Transplant Journey

Madelyn was born with a “A Hole in Her Heart” Madelyn was born with a Ventricular Septal Defect (VSD), a medium-sized murmur “A Hole in her Heart” Some of the side effects were: - Failure to thrive - Lack of energy - Inadequate eating - Very rapid breathing

On the outside Madelyn was a very happy baby

Madelyn’s Three Open Heart Surgeries November 23, 2013 December 3, 2013 Closed the “Hole” Developed Heart Block Pacemaker implanted April 23, 2013 Left Ventricle Failed Bi-Ventricular Pacemaker

Heart Transplant The doctors told us that her heart had worsened and there was nothing else they could do to fix her heart Heart Transplant Waiting List November 23 rd, 2014

The CALL March 4, 2015 - 10: 30 pm We received THE CALL from LCPH they had the perfect match for Madelyn! They took her into surgery at 2: 30 am on March 5 th, 2015

Madelyn’s Transplant March 5, 2015 • The Transplant Surgery lasted 10 hours • The new heart was a perfect match

Our New Girl • Madelyn recovered very quickly • We went home 16 days after her surgery • She was a completely different little girl • Perfusion • Big Appetite • Increased Energy • Bigger and Better Smiles

Life After Transplant

Our Normal Biopsy Schedule • Year 1 = 8 Bx • Year 2 = 4 Bx • Years 3 -5 = 2 Bx/Yr • Quarterly Center visits – ECCO’s, EKG’s, Blood Draws • • • 12 medications/day, precisely timed Frequently sick – suppressed Immune System Significant increased risk of Cancers, Diabetes etc Kidney Transplant probable Average heart will last 15 years “One Day at a Time”

Transplant Games 2018 12

Better Matching + Better Surveillance = Better Outcomes 13

Comprehensive Rejection Surveillance Gene Expression Profiling (GEP) Donor-derived Cell-free DNA (dd-cf. DNA) Immune Activity Graft Injury P-R-00005 Rev 2 Effective 07. 2018 14

Announcing… i. Box Donor-derived Cell-free DNA (dd-cf. DNA) Gene Expression Profiling (GEP) Machine learning transplant data analytics Graft Injury Immune Activity Graft Prognosis 15

Madelyn’s Heart. Care Results 17

18 Thank You