1. Lewis Teperman, MD Regional Councillor
Region 9 Meeting
Lewis Teperman, MD
Regional Councillor
Welcome to the spring Region 9 meeting. We know you took time out of your schedule to be here and your attendance is appreciated. I would also like to thank Essential Pharmaceuticals, Sanofi Genzyme and CareDx for exhibiting at our meeting today.

2. Meeting Agenda Update from OPTN/UNOS leadership
Review and discuss 6 public comment proposals, 2 concept papers
Your feedback will be shared with the DTAC, Executive, MPSC, Operations and Safety, OPO, Pancreas, Thoracic Committees
Updates on committee activities: DTAC, Kidney, Liver, Membership and Professional Standards, and Thoracic Committees
Today’s meeting includes
An update from OPTN/UNOS leadership – Dr. Yolanda Becker, OPTN/UNOS President is here
Discuss and comment on proposed policies – your feedback will be shared with the sponsoring committees
You will also hear updates from the Ad Hoc Disease Transmission Advisory, Kindey, Liver, and Membership and Professional Standards Committees.

3. Fall 2018 Regional Meeting Date
Fall public comment: August 3 - October 3, 2018
proposals will go to the Board for review in December
Mark your calendar! Fall region 9 meeting:
Wednesday, September 26th
As a reminder, public comment closes on Friday, 3/23
The regional meeting cycle runs concurrent with the public comment cycle. The fall 2018 public comment cycle will begin on August 3 and end October 3. The public comment proposals we discuss at the fall regional meeting will be reviewed by the Board in December.
The fall regional meeting will be held on Wednesday, September 26th.
As a reminder, this public comment cycle closes this Friday, March 23.

4. Region 9 Meeting Attendance
This slide shows our region’s meeting attendance over the last 3 meeting cycles compared to the nation. Region 9 data is in red (% of OPOs and transplant centers that attend the meeting) and national data is in blue. We have had 100% for the last two meeting cycles. Let’s keep it up! Our goal is to have at least one representative from each OPO, transplant center and histocompatibility lab.

5. Regional Business Welcome members of the Board of Directors
Warm welcome to new attendees at this meeting!
I would like to welcome the Board members in attendance. If you would, please stand and state your position on the Board.
Board members who might attend (all are registered): Dianne LaPointe Rudow and Carrie Lindower (and Yolanda)
I would also like to welcome the people who are attending our regional meeting for the first time. I know you will find value in today’s meeting and we are glad you are here.

6. OPTN/UNOS Volunteer Opportunities
Ongoing: submit interest in committee and Board positions throughout the year
Interested individuals must submit a bio form online
OPTN website Members tab Get Involved
Bio form includes a section to indicate specific committee and Board interest, including the position(s) you are interested in
You can indicate your interest in serving on a committee or the Board by visiting the OPTN website and completing a biography form. Information is also available on the tent card at your table.
Interested individuals must submit a bio form online to be considered for a committee vacancy. The bio form is located on the OPTN website under the members tab.
The bio form includes a section for individuals to indicate their committee and Board interests. You can also select whether you want to serve as a regional representative and an at-large member. You can select both positions if you are interested.

7. Region 9 Leadership
Regional nominating committee selected slate of candidates for Region 9 Associate Councillor election ballot
Associate Councillor/MPSC representative
Leona Kim-Schluger, MD: Mount Sinai Medical Center
Associate Councillor term: July 1, June 20, 2020
Councillor term:
Councillor beginning July 1, June 30, 2020
Rob Kochik, Finger Lakes Donor Recovery Network
Thank you to everyone who submitted a nomination to serve as a region 9 representative on the MPSC and as Associate Councillor. Rob Kochik and I selected a slate of 2 candidates to go on the election ballot.
Leona Kim-Schluger was elected as the region’s next Associate Councillor. Dr. Kim-Schluger’s term will begin in July, and Rob Kochik will begin his term as Councillor.

8. What is new today?
Electronic polling: all attendees can text a response to questions throughout the day (instructions are located at your table)
Feedback form: ONLY voting members received this form, and we are collecting additional information on 4 proposals – return to registration desk
Electronic voting: ONLY voting members have access, voting is handled through a website, NOT by texting
Voting members: please follow the instructions on your yellow or green card now, and raise your hand if you need help
Today, we will offer electronic polling for the first time today. All attendees can participate by texting responses. I will walk you through the instructions in a minute.
Voting members have 2 changes today. One, we are collecting additional feedback on 4 propsosals: OPTN Strategic Plan, Improving the OPTN/UNOS Committee Structure, Appendix L Revisions, Expedited Organ Placement Concept Paper. UNOS is piloting a new way of collecting public feedback on policy proposals with the goal of increasing public comment participation and gaining more insight into the substance of public comments. Your responses will be shared with the Committees so they can analyze public comment feedback in depth, and assist the Board in making fully informed decisions.
Voting members will submit their vote electronically through a website, NOT by texting. Let’s take a few minutes for the voting members to type in the web address located on the card they received at registration, and type in their name and UNOS code for their institution. UNOS staff will walk around and offer assistance – so please raise your hand if you need help.

9. New! Electronic Feedback
unos1
22333 D
22333
Step 1:
Step 2:
First, we will try some polling. Everyone take out your cell phones and text “unos1” to the number I’m going to pause here a moment to allow you to get out your phones.
As we go through the meeting, we will ask for your feedback on specific questions related to your experience at the regional meeting. Later in the day, we are also going to use this software to get your thoughts on the MPSC during their presentation.
As each question comes up, you will just need to text your response to the same number – Let’s get started with a test question so we can try it out.

10. A: True: Yay, that’s awesome!
Test polling question
In 2017, organs were recovered from over 10,000 donors (3.1% increase over 2016) and a total of 34,768 organ transplants (3.4% increase over 2016) were performed.
A: True: Yay, that’s awesome!
B: True: Yep, great work!
Remember to text your response (A or B) to

11. Polling question: How engaged do you feel with UNOS
Polling question: How engaged do you feel with UNOS? A) Not engaged B) Limited engagement C) Engaged D) Highly engaged
Text your response (A,B,C,D) to 22333

12. How did you prepare today to discuss the topics on the agenda?
A) Listened to a webinar or read public comment proposal(s) online
B) Waited to hear the presentations today

13. What are we here to do today?
Primary purpose: gather feedback from everyone, which requires your participation! We want you to…
Ask questions
Share your comments
Vote (regional voting members)
Network with colleagues and catch up
Share information and learn from one another
We want to remind you why we are here today. The primary reason is to get feedback from everyone here. Which means we want you to actively participate today. We want you to ask questions and share your comments. Regional voting members will vote so that we know the sentiment of the region.
We are also hear to network with colleagues, share information and learn from each other.

14. Feedback Opportunities
Your feedback is crucial to the policy development process, and we are going to ask for even more
We want to have a thorough discussion on all proposals
How will we accomplish this?
Answer specific questions the committee wants us to consider
Talk about merits of the proposals
Suggest improvements
Your feedback is key to develop policies and bylaws that are comprehensive and able to be operationalized by the transplantation and donation community.
The goal today is have a thorough discussion on each proposal. We want to know why you support a proposal and if you oppose a proposal tell us why. It is more important to know why a region votes one way or another versus the actual vote tally. The committee can’t make changes unless feedback is provided by the community.
Today, we will ask you specific questions about each proposal. We will also want to talk about the merits of each proposals and suggest ways to make them better. And, tell us what you don’t think is good about a proposal and why.

15. Regional Sentiment
Voting is another form of expressing your viewpoint about a proposal, it helps us quantify the feedback
We don’t follow a specific order for voting
Important that you understand how to express your opinion and what we are voting on vs. following a specific order
Comments and votes are our best effort to communicate regional sentiment
We do want to know the region’s sentiment about proposals; whether the voting members support or oppose a proposal because it helps us quantify the feedback.
We don’t follow a specific order for voting, so we don’t follow Robert’s Rules. We can vote on a proposal as written, vote on a proposal as is and suggest changes, sometimes in the form of an amendment, or we can identify changes and then vote. The amendment process is one way committees have found helpful to learn what revisions to the proposal would achieve broader consensus.
It is more important that you know what we are voting on versus following a specific order for voting. The feedback we get today along with the vote tally is our best effort to collect regional sentiment on public comment proposals.

16. Public Comment Opportunities
Contact Regional Representatives
List is located in the meeting booklet and on Transplant Pro: select the community tab, and then “regions”
Submit public comment online
OPTN website:
Public comment closes March 23
If you have feedback on any of the public comment proposals, you have a few ways to provide it.
You can also contact our region’s representative to the sponsoring committee. A list of our region’s representatives is located in the booklet at your seat and also on the Transplant Pro website.
You can also submit an individual public comment online through the OPTN website.

17. Regional Meeting Agenda: Non-Discussion
Includes proposals anticipated to be:
less controversial,
minimal impact on the transplant community, and/or
represent a clerical change to clarify policy or remain current with clinical practice
Region was offered an opportunity to request that a proposal(s) be placed on the discussion agenda
Proposals will be voted on today, but not presented or discussed
Proposals presented and discussed during national webinars
The proposals on the non-discussion (ND) agenda are anticipated to be less controversial, have minimal impact on the donation and transplantation community, and/or represent a clerical change to clarify the intent of policy or to remain current with clinical practice. The ND agenda is developed to give the regions more time to thoroughly discuss proposals that are controversial and have a larger impact on the community as a whole.
You were provided an opportunity to request that a proposal on the non-discussion agenda be moved to the discussion agenda. We didn’t receive any requests to remove the proposals we will vote on today from the non-discussion agenda.
The proposals on the non-discussion agenda will be voted on today, but they will not be presented or discussed.

18. Non-Discussion Proposals: Vote You have the option to abstain from voting if you haven’t reviewed the proposals
Manipulation of Waitlist Priority in the Organ Allocation System through the Escalation of Medical Therapies (Ethics Committee)
Guidance for ABO Subtyping Organ Donors for Blood Groups A and AB (Operations and Safety Committee)
Guidance on Requested Deceased Donor Information (OPO Committee)
Review Board Guidance for Hypertrophic and Restrictive Cardiomyopathy Exception Requests (Thoracic Committee)
This slide and the next one includes a list of the proposals on the non-discussion agenda that we will vote on today. **Read the title of each proposal**
Note to Councillor: Next slide includes additional proposals, please read those as well.

19. Non-Discussion Proposals: Vote You have the option to abstain from voting if you haven’t reviewed the proposals
Modification of the Lung Transplant Follow-Up Form (TRF) to Better Characterize Longitudinal Change in Lung Function following Transplantation (Thoracic Committee)
Align VCA Transplant Program Membership Requirements with Requirements of Other Solid Organ Transplant Programs (VCA Committee)
Guidance on Optimizing VCA Recovery from Deceased Donors (VCA Committee)
The plan is to take one vote on the 7 items unless anyone is opposed to a specific proposal. If you will vote to oppose a proposal, please raise your hand and we will vote on each proposal separately, or vote on the proposal you don’t support separately.
Note to councillors:
**Please remind the group that they have the option to abstain if they didn’t attend one of the national webinars to hear the proposal presented or haven’t read the proposal online.
If no hands are raised, take one vote on the 7 items: approve, oppose, abstentions
If hands are raised: vote on each proposal separately – approve, oppose, abstentions

20. Regional Meeting Materials – online!
Today’s presentations are posted on Transplant Pro
Make sure to review the non-discussion proposals and committee updates not presented today
Histo, OPO, Pediatric, Transplant Administrators, Transplant Coordinators, VCA
Regional meeting materials are also posted on Transplant Pro
All of the committee presentations and meeting materials are on the Transplant Pro website. A few committees did not present updates at today’s meeting. Please take time to review these presentations posted on the website. Meeting materials for today’s meeting are also posted on Transplant Pro.

21. New Programs in Region 9 Cohen Children’s: kidney program
Montefiore: lung program
Northwell Health: heart program
NYU: heart and lung programs
SUNY Upstate: pancreas program
Westchester: pancreas program

22. Regional and National Data

23. Deceased Donation 2016-2017 U.S. Donors Recovered Organs Recovered
Donors Recovered
Organs Recovered
Organs Transplanted
OTPD
2016
9,971
35,361
30,497
3.059
2017
10,284
36,413
31,614
3.074
% Change
3.1%
3.0%
3.7%
0.5%

24. Deceased Donation 2016-2017 Region 9 Donors Recovered Organs Recovered
Donors Recovered
Organs Recovered
Organs Transplanted
OTPD
2016
443
1,366
1,195
2.698
2017
458
1,457
1,278
2.790
% Change
3.4%
6.7%
6.9%

25. Deceased Donors by Type and Region 2017
Still a relatively small percentage of donors recovered in Region 3 are from DCD, while at least 20% of donors in Regions 1, 6, 7, 8, 9, and 10 are DCD donors. Regions 2, 3, 5, and 9 have the greatest percentages of ECDs with over 20.5%

26. Deceased Donors by Type 2008-2017 Region 9

27. Deceased Donor Transplants 2014-2017 U.S.

28. Deceased Donor Transplants 2014-2017 Region 9

29. Framing the Day We want to hear from as many attendees as possible
To manage the discussion on each proposal, please limit your comments to new comments, points that haven’t been raised
To be sure your comments and questions are heard, please use microphones

30. Questions?
Thank you for your attention and I am happy to answer questions.