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Proposal to Modify ABO Determination, Reporting, and Verification Requirements

This proposal aims to reduce the risk of accidental ABO incompatible transplants, improve transplant safety, and enhance policy consistency and clarity. It suggests aligning requirements, utilizing failure modes and effects analysis (FMEA), implementing electronic solutions, and supporting evidence from data analysis and literature review.

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Proposal to Modify ABO Determination, Reporting, and Verification Requirements

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  1. Proposal to Modify ABO Determination, Reporting, and Verification Requirements Operations and Safety Committee Spring 2014

  2. The Problem • Accidental ABO incompatible transplants – rare but devastating • Safety gaps and risk • Varying requirements and complex language: • Deceased and living donation • Candidate and donor • OPTN and CMS • Compliance issues

  3. Goal of the Proposal • Reduce risk of accidental ABO incompatible transplants • Increase transplant safety • Improve policy consistency and clarity • Align requirements

  4. How the Proposal will Achieve its Goal

  5. How the Proposal will Achieve its Goal

  6. How the Proposal will Achieve its Goal

  7. Additional Background • Failure Modes and Effects Analysis (FMEA): • Policy recommendations • Competency training and education • Electronic solutions: UNet and Electronic Tracking and Transport Project • Further aligns some requirements with CMS: • OPO deceased donor organ recovery verification • Living donor organ recovery verification scope and timing • Transplant surgeon in final pre-transplant verification

  8. Supporting Evidence • Failure Modes and Effects Analysis (FMEA) • Data analysis: • ABO policy compliance • Cases not on match run • Changes to ABO listings • Patient safety situation reporting • Literature Review

  9. What Members will Need to Do • OPOs and Transplant Hospitals will need to: • Define “qualified health care professional” in protocols • Be familiar with required verification information and acceptable sources • OPOs will need to: • Assure two blood type determination and reports completed prior to match run • Conduct deceased donor organ recovery verification • Rerun match if organ not allocated on initial run if data are updated/reported

  10. What Members will Need to Do • Transplant hospitals will need to: • Conduct living donor organ recovery verification prior to anesthesia • Conduct organ check in when organs arrive from different OR suite • Conduct pre-procedure verification when surgery starts prior to organ arrival

  11. Questions? • Jean Davis Committee Chair jean.davis@lifelinkfound.org • Name Region # Representative Email • Susan Tlusty Committee Liaison susan.tlusty@unos.org

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