Background
On 7/3/2014, the Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS) was charged with the oversight of Vascularized Composite Allograft (VCA) procurement and transplantation in the US Since 7/3/2014, 31 patients have been added to the VCA waiting list at 14 transplant (tx) centers (ctrs) within the donation service areas (DSA) of 12 Organ Procurement Organizations (OPOs) As VCA currently involves a small number of OPOs and tx ctrs, the OPTN VCA Committee conducted a survey of OPOs to determine potential barriers to VCA authorization and recovery.
Methods
An online survey developed in SurveyMonkey® was distributed to Executive Directors/CEOs of the 58 OPOs The survey was conducted for 4 weeks in March 2016.
Results
44 complete responses were received for a response rate of 76% Of the 44 OPOs, 21 (48%) had at least one approved VCA program in their DSA and 14 of the 21 OPOs (67%) had a written protocol for VCA authorization and recovery The majority (83%) of OPOs with a written protocol used a separate, additional form for the option of VCA donation Most (89%) indicated that donor registries in their DSA do not provide an opportunity to specifically authorize VCA donation Only 33% of the OPOs indicated they currently have arrangements with an authorized VCA transplant programs outside of their local DSA to recover VCAs.
Of the 26 OPOs with no written protocol for VCA authorization and recovery, 16 (62%) are considering establishing a written protocol within the next 12 months Most (54%) indicated no interest due to lack of approved local programs as a barrier for establishing a written protocol, whereas 46% indicated no barriers.
More than half (59%) of the 44 OPOs that responded indicated that they have not used the VCA educational materials and guidance documents available on the OPTN website and TransplantPro Of those who have, the majority indicated that they are useful.
Conclusions
The results of the survey underscore the need for educational efforts among OPOs, especially in OPOs with no active VCA tx ctr, to optimize VCA recovery from deceased donors and increase the number of VCA txs.