Matching organs. Saving lives.

News

UNOS and transplant professionals collaborate on innovation, improvements

For the second year in a row, UNOS and NATCO (The Organization for Transplant Professionals) explored “what is possible” to improve organ transplantation technology during NATCO’s 2018 annual meeting, August 8-11, in Indianapolis. At this year’s UNOS innovation event, transplant professional volunteers partnered with UNOS staff to identify UNetSM system enhancements. UNOS engineers created and demonstrated the proposed changes, asked participants for more feedback, and adjusted. UNOS staff also gathered additional suggestions to consider for future releases.

The first innovation event of this kind was held in October 2016, in conjunction with Association of Organ Procurement Organizations (AOPO) IT, Quality and Education councils and was a huge success based on attendee feedback.

Interested in an upcoming collaboration? UNOS innovation events are planned for the ASTS Winter Symposium in January and the UNOS Transplant Management Forum in May. Contact UNOS IT Customer Liaison Tara Taylor (804-782-4902) for more information.

Current Improvements

Transplant professionals identified improvements that they said would allow them to work more efficiently. See below for more details on the changes.

DonorNet®

Completed

  • 9/19/2018: A new feature in the organ offer reports allows DonorNet users to search by donor ID.

WaitlistSM

Planned

  • 10/18/2018: We are currently working on a way for transplant hospital staff to share user-created custom reports with others.

Previous Improvements

DonorNet®

  • 12/7/2017: OPOs can electronically notify transplant programs that they have a candidate that is primary or back-up on a match. This additional notification is meant to expedite the organ offer process by keeping centers more informed regarding their candidate’s position on the match.
  • 12/7/2017: We modified organ offer notifications so that the offers come from “DonorNet” as opposed to from the “UNOS Organ Center”.  The Organ Center’s 800 number will continue to be displayed for caller ID purposes on all offers.
  • 12/6/2017: We added five infectious disease tests (West Nile, West Nile NAT, Chagas, Chagas NAT, HTLV NAT) to the Infectious Diseases tab. We’ll also revise the  local deceased donor record XML Schema to incorporate these new test results. These results will not be required to run a match or send an electronic offer notification.
  • 10/4/2017: We added the transplant center (TXC) on-call contact name to the Offer Details section of the Match Results page. This enables users to know what person is associated with the phone number displayed so that OPO staff will no longer need to search elsewhere for contact names when calling the on-call contact.
  • 9/6/2017: Host OPOs can now print an audit log of donor blood typing and subtyping activity in DonorNet.
  • 8/23/2017: We brightened the highlight that indicates the primary patient on the match run.  The brighter highlight s legibility and helps OPOs ensure that they allocate organs in the proper sequence.

TIEDI®

  • 2/7/2018: Candidate or donor identifying information will remain at the top of the screen as users scroll down forms to enter data.

WaitlistSM

  • 8/30/2017: When removing a liver candidate from Waitlist, users now have the option to copy the most recent labs entered in the candidate record to the removal labs if they are the most recent labs available for the patient prior to removal.

Questions?

If you have questions about these system changes, please contact UNOS Customer Service at (800) 978-4334 or unethelpdesk@unos.org.

Donor hospital location updates

Audience

Transplant Centers: Directors, Administrators/Managers, Quality Review Officers, Clinical Coordinators, Data Coordinators, Compliance Officers, Physicians, and Surgeons

Organ Procurement Organizations: CEOs, Administrators/Managers, Quality Review Officers, Compliance Officers, Procurement Coordinators, and Placement Coordinators

Please share this notice with anyone in your program who would benefit from this information.

At-a-glance

On September 25, 2018, we will improve the precision of donor hospital locations in the UNOS matching system by switching from using ZIP codes to leveraging full hospital addresses.

We will be taking UNetSM down from 6:30 a.m. to 7:30 a.m. EDT on the morning of the release.

More details

This change is one of our continuous system improvement initiatives. We thank the OPOs who contributed to this effort, which allowed us to add addresses to every active hospital.  We will now more precisely pinpoint the location of a hospital, so matches that rely on distance will be exact.

We have added the street address to the drop-down list of hospital names to help you identify the correct hospital when registering a donor.

What you need to know

After we update the system on September 25, your heart and lung match runs might look a little different than they have in the past. You may notice that some transplant centers have shifted from one distribution zone to another, based on the more precise donor hospital location.

You do not need to prepare for the changes. We would request that each OPO verify their list of active hospitals and make or request address changes as needed.

Contact us

Please contact your UNOS Regional Administrator with general questions. To request a change to your donor hospital, contact UNOS Customer Service (UNet Help Desk) at 1-800-978-4334 or unethelpdesk@unos.org.

You can now submit new status justification forms for adult heart and heart/lung candidates

Audience:

Transplant administrators, clinical coordinators, data coordinators, physicians, and surgeons from heart and heart/lung programs

Implementation dates:

 Phase 1September 18, 2018: You now have access to the new status justification forms and should begin submitting them in UNet for your adult heart and heart/lung candidates. You should submit all forms by Oct. 18.

Phase 2October 18, 2018: The new adult heart allocation policy will be in effect.

At-a-glance

Adult heart allocation policy is changing and one result is that we are moving from three medical  urgency statuses to six. Read policy notice for complete details. These policy changes will require you to submit new status justification forms in UNet for all of your heart candidates.

Samples of these forms have been available in UNet since June 30 to help you familiarize yourself with the newly required data and prepare for the change. However, now you can access the actual status justification forms in Waitlist and submit them for all your candidates. This will ensure that when the policy takes effect on Oct. 18, the medical urgency status for each of your candidates is correct.

Find more specific information below about what will be different in UNet beginning Sept. 18. You will also learn more in the UNet system training available on Aug. 29.

What you should know about the new status justification forms

You must submit a new status justification form for ALL of your active candidates. If you fail to submit a form before Oct. 18, the new system will automatically assign a status 6 for your candidate, or status 5 if they are listed for at least one other organ at your center.

If your candidate’s condition changes significantly a few days before the new policy takes effect on Oct. 18, you may want to submit a new form, even if you have already submitted one. This will ensure that as soon as the new policy officially takes effect, your candidate will have the accurate status and be eligible for the proper organ offer.

Note: Submitted forms cannot be edited by anyone. Submit a new form if you make a mistake.

What you should know about risk stratification data (RSD)

The new policy requires us to collect RSD on all six status justification forms. This is brand new information that you have not been required to submit before. You must report this new information (40-50 fields) on every single status justification form (including extension forms), every single time. You will be able to indicate that you haven’t performed a particular test. We will use this information to possibly develop a heart allocation score in the future.

Reports

Between now and Oct. 18, you will have access to a report in Waitlist that will list which candidates you still need to submit new status justification forms for.  To access the report, log into UNet and from the Waitlist landing page, click on the headline Candidates pending submission of new status justification forms.

Several additional reports are available to help you prepare for this policy. You will learn more about these reports in the system training now available on UNOS Connect.

Resources

Questions?
If you have questions about how to submit the new status justification forms, contact the UNet Help Desk at 800-978-4334. Contact your UNOS regional administrator at 804-782-4800 if you have questions related to the new adult heart policy.

Now Available on the SRTR Secure Website: the Delayed Spring 2018 PSRs

SRTR’s program-specific reports (PSRs) originally scheduled to be released in July 2018 are now available on the SRTR secure website*. Transplant centers should be aware of three important changes incorporated into these reports:

  1. Adult and pediatric definitions have been updated for pre- and posttransplant metrics presented in the reports. The patient’s age at the time of registration on the waiting list is now used throughout to classify pediatric (listed before their 18th birthday) and adult patients.
  2. SRTR previously did not attempt to build risk adjustment models for posttransplant outcomes if fewer than 25 events occurred within the 2.5-year transplant cohort. This resulted in some subsets of transplant recipients having no evaluation presented in the reports. SRTR is now providing unadjusted evaluations in these instances rather than providing no evaluation at all.
  3. The delay in the release of these reports was due to a temporary loss of access to additional death information. These reports may contain additional deaths that were not known at the time of the data review period in April 2018.

Stay up to date on PSR reporting timelines. If you have any questions, please contact us at srtr@srtr.org.

* Secure site access is only available to transplant program staff.

Refreshed Data Services portal; more options, easier to use

The new Data Services application is easier to use and offers more self-service options. We plan to launch the changes in a few weeks and here’s a sample of what you can expect.

New custom visualizations
When you log in to UNet and land in the Data Services portal, you’ll automatically see a number of data charts that are specific to your OPO, transplant program, or lab. These views will help you understand at a glance some key metrics for your organization—things like the number of transplants you performed last month, or the additions and removals to your waiting list. And we’ll automatically update these charts every month.

Ease of use
You’ll be able to easily see if we’ve added a new tool or updated an existing one. And you will always know what we’ve updated within the last week. You’ll have the ability to filter data from frequently used reports and we’ve also made it easier for you to find specific documentation.

Create your own custom reports without a data request
Eighty percent of the data requests we receive involve sending OPOs and transplant centers their own data back to them. This currently requires you to submit a data request and wait a couple of weeks for custom programming and the results to be emailed to you. New functionality in the Data Services Portal allows you to now retrieve that data on your own, including transplants performed, waiting list registrations (current and historical), deceased donors recovered, and organ offers. In this section, you’ll find easy to follow instructions that will walk you through a couple options: you can start from scratch or select a report created by somebody else at your institution.. You can perform all of these on your own and get the data you need instantly.

We’ll inform you through Transplant Pro and Tech News when the new Data Services Portal is live and ready for you to explore.

Submitting LAS exception requests for candidates diagnosed with PH

Audience

We are providing this information to all lung transplant physicians, lung transplant surgeons, lung transplant coordinators, UNetSM Site Administrators, transplant program directors, and data coordinators at lung and heart/lung transplant programs. Please share this notice with anyone in your organization who would benefit from this information. This information is also posted monthly on our member website, Transplant Pro.

 Reminder: LAS Revisions were implemented on February 19, 2015

Revisions to the Lung Allocation Score (LAS) were implemented on February 19, 2015. The revisions include policy changes and changes to UNetSM. Visit the toolkit on the OPTN website for resources to help with this transition.

 Submitting Lung Allocation Score Exception Requests for Candidates Diagnosed with Pulmonary Hypertension

 Guideline

Lung transplant candidates diagnosed with pulmonary hypertension (PH) and who meet the following criteria may qualify for an increase in their Lung Allocation Score (LAS):

  1. Patient is deteriorating on optimal therapy, and
  2. Patient has a right atrial pressure greater than 15 mm Hg or a cardiac index less than 1.8 L/min/m2.

To request an increase in a PH candidate’s LAS, transplant programs must submit an exception request to the Lung Review Board (LRB); this request should include sufficient clinical detail to support that the patient meets the above criteria.

If the transplant program believes that its patient has similar waiting list mortality and potential transplant benefit as a PH patient meeting the criteria listed above, then it should provide a detailed narrative on that assertion, referencing literature supporting the request for a higher LAS. When submitting an exception request, transplant programs must provide a clinical justification for the exception. Please refer to Policy 10.2.B (Lung Candidates with Exceptional Cases) for additional information about the exception review process.

Policy 10.2.B allows a transplant program to submit an exception request for an LAS, an estimated value for one of the tests that is used to calculate the LAS, or assignment to a diagnosis group for a disease that is not listed in WaitlistSM.

 Note:  The LRB will render clinical judgment on exception requests for higher LAS, diagnosis, or estimated value.

Transplant programs may wish to submit to the LRB an exception request for the candidate’s LAS to be at the national 90th percentile (see table below).

The LAS for all active candidates greater than or equal to 12 years of age waiting for lung transplants as of August 24, 2018 are as follows:

 

Aaron McKoy (804) 782-6575If you have questions, please contact the UNetSM Help Desk at 1-800-978-4334 or unethelpdesk@unos.org. You may also contact your review board staff member: