Ad Hoc Disease Transmission Advisory Committee:
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1 Ad Hoc Disease Transmission Advisory Committee: A Report to the /UNOS Board Emily A. Blumberg, MD Chair, /UNOS DTAC Shandie Covington UNOS Staff Liaison, DTAC November 14-15, 2011 Atlanta, Georgia
2 BOD Approved Committee Projects Bi-annual DTAC e-newsletter Last issue October 2011 Highlights new HRSA-CDC Working Agreement Covers DTAC abstracts from 2011 ATC and a recent journal publication on malignancy. Guidance for Considering Donors with Meningoencephalitis of Unknown Etiology Subcommittee work ongoing Guidance document anticipated by June 2012 BOD meeting
3 BOD Approved Committee Projects Improvements to disease reporting page on Improving Patient Safety portal Modifications recommended by DTAC and DTAC support staff Committee voted to approve modifications for programming These changes will be part of a larger programming effort to update LD, Patient Safety and Disease Transmission reporting pages.
4 BOD Approved Committee Projects Proposed Minimum Screening Requirements for Living Donors Provided input and feedback to the Living Donor Committee Follow-up survey of all OPOs Regarding Donor Screening Practices On hold pending the finalization of US PHS Guidelines, as this is expected to change OPO screening practices
5 Other Projects and Issues US PHS Guidelines Review DTAC took an active role in reviewing all of the recommendations over the course of 6 conference call and through discussion. Many general and specific concerns, with feedback going into larger response from multiple committees. Committee has concerns regarding impact on transplantation as a whole.
6 HRSA-CDC Working Agreement CDC and HRSA DoT recently developed a working agreement in order to: reduce the burden on members for reporting similar information to two different organizations, and prevent duplication of effort between the CDC and DTAC. While reporting requirements outlined in Policy 4.5 will not change, the state or local public health and/or the CDC will lead and coordinate any reported PDDTE that is flagged as public health investigation.
7 HRSA-CDC Working Agreement As of October 1, 2011, a public health investigation may be pursued when a PDDTE involves: A notifiable disease (as listed by each state. Please be aware of reportable diseases in your specific locale.); A disease cluster (i.e. two or more recipients infected); or A disease or condition with public health implications (e.g. emerging pathogens, diseases with potential for person-to-person transmission).
8 HRSA-CDC Working Agreement DTAC Support Staff will continue standard case management for all malignancy and non-notifiable/nonpublic health interest cases. DTAC will continue to review all reported cases, relying on case summaries from the CDC on cases led by local or state PH or CDC.
9 HRSA-CDC Working Agreement members notified by memo in the UNOS Communications e-newsletter in October. To date, the CDC is leading 8 of the 15 cases reported in October and reviewed by DTAC. There were five additional reports that were cancelled d/t duplicate or unnecessary reporting.
10 HRSA-CDC Working Agreement To date, only one member has raised concerns regarding the new process. CDC invites DTAC to participate in any conference calls it schedules, and will provide a case summary once review is complete No summaries received to date, but we have not reached 45 day marker
11 PDTE Reviewed by DTAC January October cases reported as of 10/31/11. On pace to surpass 2010 total.
12 Summary of Reported Cases: Disease Types Jan- Oct 2011 # of Donor Reports # of Recipients w/ Confirmed Tx* # of DDD-Attributable Recipients Deaths* Bacterial Viral Fungal Parasites Other Diseases Malignancies (2 explanted) Total (2) Data on confirmed transmission and transmission-attributed deaths is based upon what is available as of 10/31/11, and does not include 45 day follow-up or SSDMF review for all events reported to date. Numbers are subject to change.
13 DTAC Members ( ) Dr. Emily Blumberg, Chair (TID) Dr. Michael Green, Vice Chair (Peds TID) Dr. Daniel Kaul (TID) Dr. Edward Dominguez (TID) Dr. Afshin Ehsan (Thoracic TX Surgeon) Dr. Michael Nalesnik (TX Pathologist) Dr. Thomas Gross (TX Oncology) Dr. Shimon Kusne (TID) Dr. George Lyon (TID) Dr. Rachel Miller (TID) Dr. Betsy Tuttle-Newhall (Abd TX Surgeon) Dr. Volker Nickeleith (Pathologist) Dr. Tim Pruett (Abd TX Surgeon) Dr. Martha Pavlakis (Nephrologist) Dr. Philip Ruiz, Jr. (Pathologist) Dr. Michael Souter (OPO Med Dir) Ms. Samantha Mitchell (OPO) Dr. Russ Wiesner (Hepatologist) Ms. Carrie Comellas (TX Coordinator) Mr. Barry Friedman (TX Administrator) Ms. Linda Weiss (OPO laboratory) Dr. Jim Bowman (Ex Officio, HRSA) Dr. Bernie Kozlovsky (Ex Officio, HRSA) Ms. Raelene Skerda (Ex Officio, HRSA) Dr. Susan Hocevar (Ex Officio, CDC)
14 Questions? Emily Blumberg, MD Univ of PA Med Center Shandie Covington UNOS Special Thanks: Sarah Taranto, Kimberly Taylor, Kimberly Parker as well as the entire Committee!
15 Thanks! Chair: Emily Blumberg, MD Vice Chair: Michael Green, MD
16
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