Modify Living Donation Policy to Include Living VCA Donors

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At a glance

What is current policy and why change it?

The Organ Procurement and Transplantation Network (OPTN) has policies that are meant to keep living donors and recipients of living donor organ transplants safe. These policies do not apply to living uterus or other living vascularized composite allograft (VCA) donors. The number of living uterus donors is increasing and the proposed change will make sure that these donors and their recipients will be protected by the same policies as other living donors.

Modify Living Donor Policy to Include Living VCA Donors

Heather Hunt, Chair of the OPTN Living Donor Committee, reviews the Modify Living Donor Policy to Include Living VCA Donors policy proposal.

Terms you need to know

• Living donor: A living individual from whom at least one organ is recovered for transplantation.
• Vascularized Composite Allograft (VCA): Transplant of multiple structures, which may include connective tissue, skin, bone, muscles, blood vessels, and nerves. For example, face and hand transplants are two of the most well-known types of VCA transplants.
• Independent Living Donor Advocate (ILDA): A person available to assist potential living donors in the living donation process.

Click here to search the OPTN glossary

What’s the proposal?

• Update policy to include all living donors, including uterus and other VCA donors
  • Require transplant programs to get information from patients about their social and psychological well being
  • Make sure that all potential living donors receive education about being a living donor, including the risks
  • Require transplant programs to do specified medical exams and tests of anyone who wants to be a living donor
  • Require an independent living donor advocate
• Add new, VCA-specific requirements
  • Medical tests important for the safety of the VCA donors and recipients of the donated organs
  • Education that will help people who want to be a VCA donor make an informed choice

What’s the anticipated impact of this change?

• What it’s expected to do
  • Require transplant programs to complete certain steps for everyone who wants to be a living uterus or other VCA donor to make sure donation and transplant is as safe as possible
  • Require all patients who want to be living donors to undergo a series of interviews, exams, and testing
  • Require transplant programs to do additional education and medical tests for people who want to be living uterus or other VCA donors
• What it won’t do
  • This will not change what is already required of people who want to be a living kidney, liver, pancreas, lung or intestine donor

Themes to consider

• Education and medical testing needed to keep living donors and recipients safe
• Education that will help someone make the decision to be a living donor

Related Proposals

Another proposal sponsored by the VCA Transplantation Committee, Update to VCA Transplant Outcomes Data Collection, was approved by the Board of Directors in June 2020 and modifies data collection for VCA transplant recipients. Updates to VCA transplant program membership requirements and the list of covered body parts pertaining to VCA were previously approved by the OPTN Board and are also pending implementation. A summary of these changes is available in a combined policy notice.

All of these proposals will be implemented together with a target completion date of June 2022 for the full body of work.

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