Transplant Insider

Quarterly Publication by Guidry & East, LLC

In This Issue
Latest News
Conference Attendance
Employment Opportunities
Quick Links

This page provides basic information about organ transplant programs.  The CMS Conditions of Participation (CoP)s for organ transplant programs were established on March, 2007, and became effective on June 28, 2007.
Consultant Spotlight

Tim Stevens 
BSN, RN, CCTC | Chief Operating Officer

Tim Stevens brings over 25 years of transplant leadership to Guidry & East. Most recently he served as the Director for Transplant Services, Mechanical Heart, and Advanced Heart Therapies at Providence Sacred Heart Medical Center and Children's Hospital in Spokane, WA. Mr. Stevens represents on several Transplant professional organization boards, committees, and workgroups. He is a current at large member of the OPTN/UNOS Board of Directors, a recent member of the OPTN/UNOS Membership and Professional Standards Committee, a past Chair of the OPTN/UNOS Transplant Administrators Committee, and is currently the Chair of the Transplant Leadership Council with The Alliance.
Mr. Stevens' experience also includes serving as Director of Transplant and Mechanical Heart at Oregon Health and Science University and Portland VA Medical Center in Portland, OR. His experience includes Transplant Quality, Transplant Program/Unit and Nephrology/Dialysis management, transplant coordination, as well as research and critical care nursing.
Mr. Stevens is a graduate of Gonzaga University and has been in healthcare for more than 35 years.
His work with transplant centers across the country is focused on his passion for the improvement of patient outcomes.
Mr. Stevens worked with Guidry & East for several years as an independent consultant before joining the firm as Principal/Partner in November 2017 and assuming the role of Chief Operating Officer in July 2018.

  Summer 2018

Guidry & East brings you  Transplant Insider ,   a quarterly publication comprised of resources and news vital to developing your transplant business solutions for growing transplant programs, improving transplant operations, and the transplant financial product line.
We look forward to being your provider of the latest policies and procedures in quality patient care.

We offer expert consulting services to Transplant Centers to bring efficiency, improve financial results, and enhance quality patient care.
Recent history has shown that you 
should not wait on engaging our Pre-emptive Independent Peer services to review your Transplant Program(s) if you had recent changes in Key Program personnel (physician(s) and/or surgeons) or suspect an upwards trend in patient deaths and graft failures. The purpose of an Independent Peer Review (IPR) is to determine, from a clinical/operational, quality, and regulatory perspective, if your Transplant Program is in compliance with the operational and outcome requirements set forth by CMS and the OPTN/UNOS. The IPR Team will identify issues that are preventing or inhibiting the Transplant Program from, among other things, attaining or maintaining full and ongoing compliance with the Medicare Conditions of Participation related to patient and graft survivals. Options for additional Transplant Program adjustments will be proposed to promote sustainability of improved outcomes.In addition, our Independent Peer Review Team (three to eight consultants) will be of assistance to your center in highlighting both short and long- term opportunities for improvement.

Contact us today.

Latest News

Call for Nominations for the 2019-2020 OPTN/UNOS Board of Directors
The OPTN/UNOS Nominating Committee is seeking nominations for the 2019-2020 Board of Directors. Voting members of the Board of Directors are elected by a vote of the entire membership and serve as volunteers without compensation.

Individuals may self-nominate or nominate others by submitting a  biography form.

Read  here.
Improving the Transplant System with Collaborative Research
UNOS Principal Research Scientist Darren Stewart describes the start of UNOS Labs and talks about the first two experiments on physician offer-acceptance behavior.

UNOS staff regularly collaborate with members and industry experts on projects to improve the transplant system and increase the number of transplants performed.

In order to further such work, we created a virtual research center known as UNOS Labs. UNOS Labs is an experimental incubator that brings together data, technology, and industry expertise.

Read  here.
Recently Published White Paper Explores Ethical Aspects of Manipulating Waitlist Priority
At its June 2018 meeting, the OPTN/UNOS Board of Directors approved the publication of an Ethics committee white paper titled Manipulation of the Organ Allocation System Waitlist Priority through the Escalation of Medical Therapies. You can  access this paper  from the OPTN website.

Full Article  here .
American Society of Transplantation
Innovation Award 
Transplantation was founded on the spirit of innovation and experimentation. AST created the Innovation Award to honor an individual or team whose big ideas and outside the box thinking has made a significant impact on transplantation. The award is designed to showcase successes in transplant innovation and to drive, recognize, and reward novel ideas.

Deadline: October 12, 2018

Read  here .
Should UNOS Yield to Competition?
This month's installment of "The AJT  Report" delves into the emerging discussion over the renewal of the UNOS contract for management of the organ procurement and transplant system. We also share information on how authors can optimize Wiley's Transplant Peer Review Network when submitting manuscripts.

Metabolic Control of T Cell Memory
To meet the increased energy requirement associated with cell division and effector function, primed T cells undergo a metabolic switch from oxidative phosphorylation to aerobic glycolysis. As memory T cells are functionally defined by their ability to respond more quickly to restimulation than naïve cells, memory cells may adapt their metabolism to support a rapid response. Bantug et al find that the rapid effector response by restimulated memory CD8+ T cells is supported by an increased respiratory rate, which promotes the production of extra-mitochondrial acetyl-CoA downstream of the tricarboxylic acid (TCA) cycle. This acetyl-CoA may be used as a substrate for histone acetylation at sites critical to T cell effector function, including the interferon-γ (IFN-γ) locus.

Wiley Online Library

Read  here .
And Equal Access for All? The Future of Deceased Donor Kidney Allocation
Stewart and colleagues have developed a new metric to assess equity in access to deceased donor kidney transplant to further facilitate efforts to reduce existing geographic disparities.

End-stage renal disease (ESRD) and its comorbidities do not affect patients differently based upon where they live. However, access, referring to both referral for evaluation for kidney transplantation and equitable allocation of organs to those on the list, is very different depending on place of residence. 1 This is a complicated problem with many facets including regional differences in the prevalence of kidney disease, access to health care, availability of suitable deceased donor organs and the organ acceptance practices of transplant centers. 1Additionally, until now a method of measuring the disparity in access to kidney transplantation did not exist hampering efforts to study the problem. In this issue of the journal, Stewart and colleagues demonstrate the utility of a novel approach for assessing disparity in access to kidney transplantation by comparing the patient experience pre and post implementation of the kidney allocation system (KAS). 2 The result of their efforts is a composite metric called the Access to Transplantation Score (ATS). Assessed by this new metric, KAS, which was implemented in December 2014, has significantly and durably decreased the disparity in allocation of kidneys to African Americans and for all sensitized candidates except those with calculated Panel Reactive Antibodies (cPRA) greater than 99.5%. However, inequality still exists.

Read  here .
Public Comment
The OPTN policy development process incorporates feedback on policy and bylaws proposals, before the proposals go to the OPTN board of directors for approval. Public comment is an essential part of the policy development process.

All interested individuals are welcome to participate, especially transplant candidates, who are most affected by policies. The OPTN welcomes public comment on all open policy proposals. We consider every comment we receive about a proposal before the OPTN board of directors votes on it. We are especially interested in hearing from transplant professionals about any significant financial impact a proposal could have on their organization. Feel free to include this information when you provide your feedback. 

Public comment is open  August 3 - October 3.

Read  here .
NLRB, Liver Distribution Implementation Postponed
The OPTN/UNOS Liver and Intestinal Organ Transplantation Committee continues further policy development on both the national liver review board (NLRB) and liver distribution policy. The committee is working to replace the local donor service area (DSA) and region as specific units of distribution with an alternative geographic framework. As a result, neither the NLRB nor the previously approved liver distribution policy will be implemented in 2018 as originally scheduled.

The committee plans to publish revised NLRB and liver distribution proposals for special public comment in October 2018. Its goal is to bring final proposals for the OPTN/UNOS Board of Directors to consider at its December 2018 meeting.

Read  here .
Constituent Council Initiative Tests Options to Improve Committee Structure
The Executive Committee is sponsoring a proof of concept project to test options to improve the OPTN/UNOS Committee structure through enhanced communication and engagement.

In spring 2018 public comment, feedback to the  concept paper entitled "Improving the OPTN/UNOS committee structure" indicated significant concerns about specific recommendations, but general support for the overarching goals of broadening committee engagement, improving intra-Committee communication, and increasing engagement between the Board and committees.  The Executive Committee carefully considered feedback. They discussed forging ahead with a formal proposal based on the concept paper, abandoning the project, or testing a modified version of the proposed structure that addresses concerns raised during public comment. Ultimately, they decided to pursue this latter option.

The proof of concept, which will be tested during the fall public comment cycle, maintains the original structure and purpose of all committees.  It also maintains the ability for any committees to sponsor policy projects.

Read  here .
Ad Hoc Committee Formed to Address OPO, Transplant Center, System Metrics
A new ad hoc committee will focus on studying the systems and relationships among OPOs and transplant centers. It will identify tools and principles that can be used to drive collaborative transplant systems performance improvement.

The OPTN/UNOS Ad Hoc Systems Performance Committee consists of three workgroups. They will study existing metrics and effective practices and recommend new or updated ways to assess and improve performance. The workgroups will share recommendations and seek additional input from the donation and transplant community as well as the general public at a meeting in March 2019.

The workgroups will share recommendations as applicable with the donation and transplantation community and the public for individual application, with the OPTN/UNOS Board and committees involved in quality assessment, and with federal agencies involved in oversight of organ donation and transplantation.

Read  here .
Public Comment Sought (1)
The Organ Procurement and Transplantation Network (OPTN) offers policy proposals for public comment from August 3 through October 3, 2018.

Comments and replies will be published on the OPTN public comment page, to promote transparency and trust in the national transplant system. Visitors can also share comments on social media, if they wish.

We encourage patients, transplant candidates and recipients, living donors, donor families and transplant professionals to learn more about the proposals below and  provide valuable feedback  to help shape U.S. organ transplant policy:
  • Changes to Islet Bylaws (Pancreas Transplantation Committee)
  • Frameworks for Organ Distribution Ad Hoc Geography Committee)
  • Change to Hospital-Based OPO Voting Privileges (Membership and Professional Standards Committee)
  • Pancreas Program Functrional Inactivity (Pancreas Transplantation Committee)
  • Pediatric Transition and Transfer Guidance Document (Pediatric Committee)
  • Addressing HLA Typing Errors (Histocompatibility Committee)
Read  here .
Changes to Adult Heart Allocation Policy Effective this Fall
Start Preparing Now
We'll implement phase one of a change to heart allocation policy on September 18, 2018 and phase two on October 18.
These changes will:
  • better stratify the most medically urgent heart transplant candidates
  • reflect the increased use of mechanical circulatory support devices (MCSD) and prevalence of MCSD complications, and
  • address geographic disparities in access to donors among heart transplant candidates
Read  here .

Conference Attendance

THANK YOU TO ALL  who stopped by the Guidry & East booth at the 31st Annual Scientific Meeting of Texas Transplantation Society  July 26-29 in San Antonio, Texas.   We enjoyed talking to everyone and meeting new Transplant professionals.

We look forward to seeing you in Minneapolis! 
Stop by our booth for a quick consultation to discuss  business solutions that will benefit your transplant center.

Find conference details and registration here.

Employment Opportunities

TLI has been retained by LifeNet Health to identify and recruit a General Manager for their Northwest Region based in Renton, Washington.  This position services as the Senior Executive and leader for all sites comprising LifeNet Health Northwest operational territories.  Works collaboratively with division and corporate leadership (e.g. Sales, Marketing, Quality, Research and Development, Tissue Donor Operations, Production and Logistics, Human Resources, and Donor Development) to develop strategies and tactics for achieving growth of LifeNet Health in all aspects throughout assigned operational territory.

Establishes, develops, and maintains effective relationships and a network of C-suite contacts throughout all client organizations.  This highly matrixed position functions collaboratively with divisional and corporate leadership to guide all daily operations within the assigned service area.  Supervises, guides, direct and develops strategies that impact the long-term success of the company. Provides critical assessment of strategy and tactics while maintaining focus on the corporate Mission, Vision, and Values.
Requirements for the position are:
  • Bachelor's degree in Medical Sciences, Business Administration, Healthcare Administration, Public Relations, or Life Sciences. MS/MBA preferred.
  • Eight years of management experience with direct reports, multiple sites, technical personnel, community partners.
  • Five years' experience of related work experience in Tissue Banking, Blood Banking, OPO, Healthcare, Life Sciences, Multi-care, or Medical Device.
  • Five years' experience in new business development, marketing, community relations
    CTBS Preferred or within 3 years of hire.
Contact for more information.

Career Moves

Sherry Clark is no longer with CMS.  We wish her all the best in her retirement!

Updated contact information: 

Tennille Rogers at or call 410-786-5878

For organ transplant issues:

For immediate assistance with transplant issues Peggye Wilkerson at or call 410-786-4857


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