Thursday, November 30, 2023

UNOS ends its liver exchange pilot program

UNOS has shuttered it's liver exchange pilot program, after less than a year, without having performed any liver exchange transplants. (My understanding is that this wasn't part of UNOS's OPTN contract, but part of its activities as a private company.)

A colleague forwarded me this announcement:

"After careful consideration and evaluation, we regret to announce the discontinuation of the UNOS Liver Paired Donation Pilot Program (LPDPP).

The UNOS LPDPP was launched with the noble goal of matching candidates in need of a liver transplant with living donors from across the United States. Top-tier transplant programs from around the country participated in the program, entering pairs to be matched for transplantation.

 Despite the enthusiasm and dedication of the UNOS LPDPP Steering Committee, participating hospitals, a visionary funder and UNOS Labs staff, we must acknowledge that the program faced significant challenges. Regrettably, no matches were made, and no transplants occurred during the course of the pilot.

 This decision to discontinue the program is a result of several factors, primarily the depletion of funding allocated to the pilot and other barriers to widespread adoption. While practical constraints have led us to this difficult decision, we are still committed to uncovering key insights that may help future efforts toward a national liver paired donation program and apply to other challenges facing the organ donation and transplant community.

 We would like to express our heartfelt gratitude to the Steering Committee, participating transplant programs’ staff, candidates and donors who agreed to be entered and the generous living liver recipient who funded this endeavor. Your dedication to saving lives through organ transplantation is truly commendable. These efforts have yielded valuable data and insights that will allow our community to continue to advance.

 While this chapter may be closing, our commitment to increasing the number of lives saved through organ donation and transplant remains unwavering. We will continue to explore innovative ways to improve access to organ transplants for those in need. We will be doing more investigation into the program’s barriers to success, unexpected challenges and opportunities for improvement, and we plan to share our discoveries with the community so we may all learn from the results.

 The program will officially end November 30, 2023, with the last match run on September 30, 2023."



Friday, January 27, 2023

Liver exchange pilot program at UNOS

see also, from UNOS:

and this, from Medscape:

"It is possible that the 1-year pilot program could run without performing any paired transplants, but that's unlikely if multiple pairs are enrolled in the system, the spokesperson said. At the time of this story's publication, the one enrolled pair are a mother and daughter who are registered at the UCHealth Transplant Center in Colorado.
"The pilot program requires that the donor bring one support person with them if they need to travel for the surgery, but undergoing major abdominal surgery from a transplant team they are not familiar with may be stressful, said Peter Abt, MD, a transplant " at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia. "That's a big ask," he said, "and I'm not sure many potential donors would be up to that."

"John Roberts, MD, a transplant surgeon at the University of California, San Francisco, agreed that the travel component may put additional stress on the donor, but "if it's the only way for the recipient to get a transplant, then the donor might be motivated," he added.
"Leishman agreed that the travel aspect appears to one of the greatest barriers to participants entering the program but noted that a goal of the pilot program is to understand better what works — and what doesn't — when considering a liver paired donation program on a national scale. "[Our] steering committee has put together a really nice framework that they think will work, but they know it's not perfect. We're going to have to tweak it along the way," she said."

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