1. Vascularized Composite Allograft (VCA) Transplantation Committee
Fall 2018

2. 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

3. Upcoming Policy Implementations
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
Aligning VCA Membership Requirements with Requirements for Other Transplant Programs
Achieve greater alignment between VCA membership requirements and solid organ transplant requirements
Application period target Q2 2019
Two new proposals were approved by the Board in June 2018:
Guidance to OPOs to Optimize VCA Authorization and Recovery is available on the OPTN website now.
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

4. Future Projects Proposal Status Understanding VCA Transplant Outcomes
Modify recipient data collection to have better understanding of VCA transplant outcomes
Ongoing discussions
Public comment target – August 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 August 2019.

5. Approved VCA Transplant Programs* as of 7/6/2018
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 July 6, 2018.
Data subject to change based on future data submission or correction.

6. VCA Waiting List and Transplant Numbers by Type as of 7/6/18
VCA Type
Candidates Added to Waiting List, 7/3/2014-7/6/18
Transplants, 7/3/2014-7/6/18
Candidates Waiting as of 7/6/18
Abdominal Wall 4 1 2
Head & Neck: Craniofacial 11 6
Head & Neck: Scalp
Upper Limb, Bilateral 3
Upper Limb, Unilateral 10
Other: GU - Penile
Other: GU - Uterus 20 12 8
Total 63 32 21
Based on most recent available information provided by members to the OPTN as of July 6, 2018.
Data subject to change based on future data submission or correction.

7. Questions Linda C. Cendales, M.D. Chair, VCA Transplantation Committee
Christopher L. Wholley, M.S.A.
Policy Analyst