1. Pediatric Transplantation Committee Spring 2014

2. Pediatric Transplant Training & Experience  Fall regional meeting feedback recurring themes:  Negative impact on pediatric candidates’ access  Case volumes too high  Transplanting larger pediatric patients should not require “pediatric component” approval  Lack of supporting data Ongoing Committee Initiatives

3.  Simplify!  Only focus on experience with transplant patients younger than 18  Experience not required over 5 year period  Data  No significant numerical data Changes in Response

4. Pediatric Primary Kidney Surgeon  Meet current Bylaws for Primary Kidney Surgeon  12 Kidney transplants in patients younger than 18 Pediatric Primary Kidney Physician Meet Bylaws requirements outlined in one of the following sections of Appendix E (Membership and Personnel Requirements for Kidney Transplant Programs), Section E.3 (Primary Kidney Transplant Physician Requirements):  3.C (Three-year Pediatric Nephrology Fellowship Pathway)  3.D (Twelve-month Pediatric Transplant Nephrology Fellowship Pathway)  3.E (Combined Pediatric Nephrology Training and Experience Pathway) Pediatric Kidney Component Qualifying Criteria

5. Pediatric Primary Liver Surgeon  Meet current Bylaws for Primary Liver Surgeon  18 liver transplants in patients younger than 18 Pediatric Primary Liver Physician Meet Bylaws requirements outlined in one of the following sections of Appendix F (Membership and Personnel Requirements for Liver Transplant Programs), Section F.3 (Primary Liver Transplant Physician Requirements):  3.C (Three-year Pediatric Gastroenterology Fellowship Pathway)  3.D (Pediatric Transplant Hepatology Fellowship Pathway)  3.E (Combined Pediatric Gastroenterology/Transplant Hepatology Training and Experience Pathway) Pediatric Liver Component Qualifying Criteria

6. Pediatric Primary Heart Surgeon  Meet current Bylaws for Primary Heart Surgeon  8 heart transplants in patients younger than 18 Pediatric Primary Heart Physician  Meet current Bylaws requirements for Primary Heart Physician  Care for 8 heart transplant patients younger than 18 years of age  American Board of Pediatrics: Sub-board of Pediatric Cardiology Certification Pediatric Heart Component Qualifying Criteria

7. Pediatric Primary Lung Surgeon  Meet current Bylaws for Primary Lung Surgeon  4 lung transplants in patients younger than 18 Pediatric Primary Lung Physician  Meet current Bylaws requirements for Primary Lung Physician  American Board of Pediatrics certification in pulmonology medicine possessed by the individual who meets the current bylaw requirements OR another member of the lung transplant team. Pediatric Lung Component Qualifying Criteria

8.  Conditional Pathway for “Pediatric Component”  Eliminate Alternative Pathway for Predominantly Pediatric Programs  Acute fulminant liver or cardiac failure requiring urgent transplant in an adult program for logistical reasons Additional Considerations

9.  Heung Bae Kim, M.D. Committee Chair heung.kim@childrens.harvard.edu  Name Region # Representative name@email  Chad Waller Committee Liaison chad.waller@unos.org Questions?