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A community message from the OPTN Board of Directors

Community

A community message from the OPTN Board of Directors

Dear colleague,

All of us who work in organ donation and transplantation recognize that serving the donor families, living donors, transplant candidates and recipients who depend on us for their care requires us all to work together and share our unique expertise and perspectives.

The amount of coordination and cooperation that must take place in our community is unique among all clinical disciplines. This makes it critical that as the OPTN, we have a strong policy development process that depends on broad input from the community and public and that considers all views fairly. As the OPTN develops policies for the equitable allocation of organs, those policies are made stronger by respectful debate among a broad spectrum of committed stakeholders. The patients we serve are the ultimate beneficiaries of our strong policy development process.

Matthew Cooper, M.D.

Matthew Cooper, M.D., FACS, President

Jerry McCauley, M.D., M.P.H.

Jerry McCauley, M.D., M.P.H., FACP, Vice President / President-Elect

David C. Mulligan, M.D.

David C. Mulligan, M.D., FACS, FAASLD, FAST, Immediate Past President

The liver acuity circles allocation policy, implemented more than two years ago, has been a key to improving transplant equity. As you will recall, it occurred in a challenging environment, but our Board and committees were committed to following all steps of the policy development process. Ongoing monitoring of the effects of the resulting policy continues to show it meets expectations for improvement in key metrics.

Some members of our community recently expressed specific concerns with OPTN governance as it related to the liver policy development process. They claimed that there has been specific bias against member institutions in their part of the country. We take these matters very seriously.

Your OPTN Board of Directors met in closed session on March 16 to consider these concerns as well as the source materials that prompted them. It was a thorough and frank discussion. It was appropriate to consider all views and evidence in the spirit offered and in the broad context of the OPTN’s responsibilities.

Ultimately the Board resolved, by a vote of 29-1, with one abstention, that the OPTN properly followed the policy development process that resulted in the acuity circles liver allocation policy. Our Board further concluded that the Board in place in December 2018 adopted this policy after a free and independent review of data, modeling, extensive public comment and other evidence presented to it.

By the same vote, the Board commended Brian Shepard, the OPTN executive director, for his performance throughout the development of the liver acuity circles policy and its successful implementation. The Board also found no merit in additional allegations that either Alexandra Glazier or other OPTN volunteers had improper motives or influence in the collective process in which all of us, as OPTN members, have a voice.

In the two years since the liver policy has taken effect, our entire field has not only persevered but achieved record performance despite a devastating pandemic. This achievement speaks to our individual dedication to the patients and donors we serve. It is made ever stronger by our shared commitment to the lifesaving work of the OPTN in continuing to improve organ allocation policy. We have also recently passed the one-year anniversary of the updated national kidney allocation policy, which early monitoring indicates is performing well and as expected. The recent lawsuit challenging the policy’s development has now been dismissed.

Even now we are moving toward a framework of continuous distribution, which presents a new opportunity for us to contribute in a collective fashion, unite and move forward. In fact, the recent report from the National Academies of Sciences, Engineering and Medicine recommends that the work on continuous distribution be accelerated.

The future and opportunities are bright for the OPTN, and we should all agree that continued personal attacks have no place in this effort. Let us proceed with a singular focus toward providing a lifesaving transplant for all who need them.

Matthew Cooper, M.D., FACS, President

Jerry McCauley, M.D., M.P.H., FACP, Vice President / President-Elect

David C. Mulligan, M.D., FACS, FAASLD, FAST, Immediate Past President

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