Vascularized Composite Allograft VCA Transplantation Committee Spring 2019

Vascularized Composite Allograft (VCA) Transplantation Committee Spring 2019 1

Recently Implemented Projects Proposal Guidance to OPOs on Optimizing VCA Authorization & Recovery • Share effective practices for VCA authorization & recovery Board Approval Implementation Date June 2018 June 12, 2018 2

Upcoming Policy Implementations Proposal Membership Requirements for VCA Transplant Programs • Established minimum training and experience requirements for key personnel 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 Board Approval Implementation Date June 2015 Application period target Q 2 2019 June 2016 Application period target Q 2 2019 3

Upcoming Policy Implementations Proposal Aligning VCA Membership Requirements with Requirements for Other Transplant Programs • Achieve greater alignment between VCA membership requirements and solid organ transplant requirements Board Approval June 2018 Implementation Date Application period target Q 2 2019 4

Future Projects & Initiatives Proposal Understanding VCA Transplant Outcomes • Modify recipient data collection to have better understanding of VCA transplant outcomes Collaboration with AOPO • Increase deceased donors screened for VCA donation Status • Ongoing discussions • Public comment target – January 2020 • Ongoing through 2019 5

Approved VCA Transplant Programs* as of 1/18/2019 VCA Program Type Number Abdominal Wall Head and Neck Upper Limb 15 17 19 Other VCA • Genitourinary – Uterus • Genitourinary – Penis • Genitourinary/Urogenital • Lower Limb • Musculoskeletal Composite Graft Segment Total 5 2 3 2 1 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. 6

VCA Waiting List and Transplant Numbers by Type as of 1/18/19 Candidates Added to Waiting List, 7/3/2014 -1/18/19 Transplants, 7/3/20141/18/19 Candidates Waiting as of 1/18/19 Abdominal Wall 7 2 2 Head & Neck: Craniofacial 11 6 4 Head & Neck: Scalp 2 1 1 Upper Limb, Bilateral 12 7 3 Upper Limb, Unilateral 10 4 2 Other: GU - Penis 3 2 0 Other: GU - Uterus 30 17 12 Total 75 39 24 VCA Type 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

Questions § Linda C. Cendales, M. D. Chair linda. cendales@duke. edu § Bohdan Pomahac, M. D. Vice Chair bpomahac@partners. org § Christopher L. Wholley, M. S. A. Transplant Community Administrator christopher. wholley@unos. org 8