Published for Members of the American Society of Transplant Surgeons

35th Anniversary Vol. XV, No. 1 Summer 2009

President’s Letter 4 Member News 6 Regulatory & Reimbursement 8 Legislative Report 10 OPTN/UNOS Corner 12 35th Anniversary of ASTS 14 Winter Symposium 18 Chronicles 19 American Transplant Congress 2009 20 Beyond the Award 23 ASTS Job Board 26 Corporate Support 27 Foundation 28 Calendar 29 New Members 30

www.asts.org ASTS Council May 2009–May 2010

Pr e s i d e n t Tr e a s u r e r Charles M. Miller, MD (2011) Robert M. Merion, MD (2010) Alan N. Langnas, DO (2012) Cleveland Clinic Foundation University of Michigan University of Nebraska Medical Center 9500 Euclid Avenue, Mail Code A-110 2922 Taubman Center PO Box 983280 Cleveland, OH 44195 1500 E. Medical Center Drive 600 South 42nd Street Phone: 216 445.2381 Ann Arbor, MI 48109-5331 Omaha, NE 68198-3280 Fax: 216 444.9375 Phone: 734 936.7336 Phone: 402 559.8390 Email: [email protected] Fax: 734 763.3187 Fax: 402 559.3434 Peter G. Stock, MD, PhD (2011) Email: [email protected] Email: [email protected] University of California San Francisco Pr e s i d e n t -El e c t Co u n c i l o r s -a t -La r g e Department of Surgery, Rm M-884 Michael M. Abecassis, MD, MBA (2010) Richard B. Freeman, Jr., MD (2010) 505 Parnassus Avenue Tufts University School of Medicine San Francisco, CA 94143-0780 Division of Transplantation New England Medical Center Phone: 415 353.1551 675 North St. Clair Street, #17-200 Department of Surgery Fax: 415 353.8974 , IL 60611 750 Washington Street, Box 40 Email: [email protected] Phone: 312 695.0359 Boston, MA 02111 R. Mark Ghobrial, MD, PhD (2012) Fax: 312 695.9194 Phone: 617 636.5592 The Methodist Hospital Email: [email protected] Fax: 617 636.8228 Department of Surgery Email: [email protected] Im m e d i a t e Pa s t Pr e s i d e n t 6550 Fannin Street, SM 1661 John P. Roberts, MD (2010) Dixon B. Kaufman, MD, PhD (2010) Houston, TX 77030 University of California San Francisco Northwestern University Med School Phone: 713 441.6936 Division of Transplantation Department of Surgery Fax: 713 793.7151 505 Parnassus Avenue Division of Transplantation Email: [email protected] Box 0780, Room M896 675 North St. Clair Street Robert S. Higgins, MD, MSHA (2012) San Francisco, CA 94143-0780 Galter Pavilion Suite 17-200 Rush Presbyterian St. Luke’s Phone: 415 353.1888 Chicago, IL 60611 Medical Center Fax: 415 353.8709 Phone: 312 695.0257 Department of Cardiovascular Email: [email protected] Fax: 312 695.9194 & Thoracic Surgery Email: [email protected] Pa s t Pr e s i d e n t 1725 W. Harrison Street, Suite 1156 Goran B. Klintmalm, MD, PhD (2010) Timothy L. Pruett, MD (2010) Chicago, IL 60612 Baylor Regional Transplant Institute University of Virginia Phone: 312 942.6373 3500 Gaston Avenue Department of Surgery Fax: 312 563.4700 Dallas, TX 75246 PO Box 800709 Email: [email protected] Phone: 214 820.2050 Charlottesville, VA 22908-0709 Elizabeth A. Pomfret, MD, PhD, FACS Fax: 214 820.4527 Phone: 434 924.9462 (2012) Email: [email protected] Fax: 434 924.5539 Lahey Clinic Medical Center Email: [email protected] Department of Transplantation Se c r e t a r y Kim M. Olthoff, MD (2011) 41 Mall Road, 4 West James D. Eason, MD (2011) Burlington, MA 01805 University of Hospital Methodist University Hospital Phone: 781 744.2500 Department of Surgery University of Tennessee Fax: 781 744.5743 3400 Spruce Street, 2 Dulles Department of Surgery Email: [email protected] Philadelphia, PA 19104 Transplant Institute Phone: 215 662.6136 1265 Union Avenue Na t i o n a l Of f i c e Fax: 215 662.2244 10 Service, S1011 Katrina Crist, MBA Email: [email protected] Memphis, TN 38104-3499 Executive Director Phone: 901 516.7070 2461 South Clark Street, Suite 640 Fax: 901 516.2036 Arlington, VA 22202 Email: [email protected] Phone: 703 414.7870 Fax: 703 414.7874 Email: [email protected]

2 Chimera Summer 2009 www.asts.org Editor’s Letter 35th ASTS Celebrates 35 years Anniversary

When one considers the origin of ASTS, its subsequent astonishing growth elicits a sense of genuine pride and accomplishment. This growth can be measured in many ways, including membership, meeting attendance, abstracts submitted and accepted, and committee and council activity. – Oscar Salvatierra, Jr., MD, original charter member

Dr. Salvatierra, an active ASTS member today, said it best. Looking back, the focus of the Society has not changed. ASTS remains committed to the foundation established in its early years: members are a top priority, the meetings are scientifically relevant, the research submitted is more promising, and the committees and council have grown rapidly.

What began with 16 surgeons at a meeting in Rockville, Maryland has blossomed into a society of over 1500 members dedi- cated to the advancement of transplantation. And these members are grateful for the path paved by pioneers in the field.

ASTS started in the mid 70’s with 7 committees and 8 council members. Today, ASTS has 23 standing committees, 4 ad hoc committees, 4 task forces and 15 council members. Many members recall the intimate meetings at the Drake Hotel in Chicago, where members met not only to discuss transplantation but for the camaraderie. Today, the Winter Symposium holds the same purpose, and remains small for a reason, to provide an atmosphere where members can discuss new research and interact with colleagues. Dr. Salvatierra goes on to say,

The impressive growth and maturation of ASTS to its current status well exceeded the expectations, dreams and hopes of the original founders. This multifaceted growth has better allowed us to achieve the goal articulated in our bylaws: to promote transplantation science through research and education for the optimal benefit of recipients of organ transplants. A particularly unique stimulus has been the education and training of surgeons to perform transplantation of all organs and to be exposed to evolving transplant immunobiology. Not surprisingly, ASTS is now recognized by many as the principal forum and voice of in this hemisphere. In effect, the history of ASTS reflects the history and growth of U.S. transplant surgery for the past two decades.

The passages were written in 1994, but carry the same sentiment today. As you flip the pages of this issue, you’ll discover more about the history of ASTS, gain insight from our new President, Dr. Robert M. Merion, as he discusses new technological trends, and learn more about the importance and benefits of receiving ASTS research awards and other current events.

Join me as we celebrate 35 years of success!

Best Regards, James Whiting, MD Chair, Communications Committee

Chantay Parks Moye Managing Editor [email protected]

Karol A. Keane Design & Communications, Inc. www.karolkeanedesign.com

About the Cover

As we celebrate 35 years of advancing transplantation, we want to show you where it all began. The cover is a photo of the first ASTS president Thomas E. Starzl, MD, PhD. Dr. Starzl is a pioneer transplantation surgeon, having performed the first human transplant in 1963. You may also know him for his exceptional accomplishments in and his work to develop better drugs to make human organ transplants safer. Many second-generation transplant surgeons may know him best as their mentor, trainer, and friend. Many others may know him as the modern day father of transplantation. Use the following link to read more about Dr. Starzl’s astonishing career and his contribution to a field once described as unheard of,http://www. upmc.com/MediaRelations/Experts/pages/ExpertsPage.aspx?ExpertID=230.

www.asts.org Chimera Summer 2009 3 President’s Letter

s I compose my firstChimera Similarly, the ASTS Council ques- column as president of the tioned at one time whether there would AAmerican Society of Transplant ever be a reason to communicate with Surgeons on my laptop, I recognize the members using any medium other than enormous privilege and highlight of my a stamped postmarked letter hand- professional career it is to have had this delivered to your office by a uniformed honor bestowed on me. I follow a long Postal Service carrier in line of distinguished past presidents (35 shorts. Although our venerable Chimera to be exact) in whose company I feel newsletter is still printed and distributed awed and humbled. At the conclusion of by mail, for the past several years it has the 2010 American Transplant Congress also been available in an online version, meeting in San Diego when my presiden- which some of you are viewing right now cy is concluded, I hope that the ASTS (perhaps on a smartphone). Are the days will be an even better and more relevant of the print version numbered? I think society than it is today. the Chimera will eventually move to an online-only format like many newspapers Are you talking to me? Robert M. Merion, MD and magazines, but the ultimate form it ASTS President takes will be our decision to make. “ASTS promotes collaboration with Medicare, FDA, and HRSA in promot- ber. Every year, we went through the ASTS sends out informative emails ing patient welfare and member interests; process again, and most members then about once a week that you hopefully help us to be better advocates.” threw away the old version. I was one of read. However, we’re re-examining this a group of nerdy ASTS members – hard one-size-fits-all approach as our society’s “ASTS needs you to write or call your to picture, I know – who recommended rapidly growing 1500-strong member- state’s congressional delegation today to that we put the directory online on the ship and activities become increasingly urge inclusion of extension of immuno- new ASTS website and stop printing the diverse. Jim Whiting and the ASTS suppression coverage.” paper version. I got a lot of pushback Communications Committee are in the initially, but eventually it happened. The process of rolling out RSS feeds (really “The ASTS Winter Symposium, to be hard-copy directories are hardly even simple syndication, for those of you who held in Ft. Lauderdale on January 15- remembered now, and the online direc- are curious), which will allow you to sub- 17, 2010, has issued a call for scientific tory has the advantage that it is updated scribe to the information that’s of most abstracts.” in real time as members notify the office interest and importance to you. that they’ve moved, and as new members Aside from being true, what is the join our expanding society. The data be- I’ve also asked them to explore a poten- common characteristic of each of these hind all of this formed the nucleus of our tial role for social media networking tools sentences? Well, if you have an account society database, which has since been like Twitter. In case you’re not familiar with the online social media network expanded to allow us to integrate with with Twitter, it allows you to send a short Twitter, you probably noticed that each communications tools, the new online burst of information in real time – a one is shorter than the 140-character curriculum, fellowship tracking, billing, 140-character tweet – to all the people limit for a tweet. “Wait a second,” you and many other society functions and who are interested in you or the topic say. “What’s Twitter and what does it services. We’ve even talked about using you’re tweeting about. have to do with the ASTS?” Read on, it to help study job stability by tracking and we’ll explore together how embrac- address changes over time. The transi- NASA has been using Twitter to update ing new technology can help the ASTS tion to an online directory has saved thousands who are interested in the space to achieve its goals. the ASTS at least $80,000 in direct program. When the Iranian election in costs over the past five years. But, more June resulted in widespread protests and Technology isn’t new to ASTS. It was importantly, it laid the foundation for us the government shut down all of the only a few years ago that the ASTS pro- to better and more efficiently serve our conventional news media, a new form of duced an annual printed version of the members in ways that could have never reporting using Twitter emerged almost membership directory. We spent about been anticipated at the time. instantly. But if these examples seem ir- $20,000 per year on it, and then spent relevant to transplantation, consider that more money mailing one to each mem- ASTS members Drs. Dev Desai and Juan

4 Chimera Summer 2009 www.asts.org Arenas provided a real time Twitter feed The process currently in place from the operating room to the donor vests responsibility in our and recipient’s family in the waiting Nominating Committee to receive room during a recent living donor kidney nominations for the elected offices transplant in Dallas (http://tinyurl.com/ of president-elect, secretary, trea- twitter-kidney). A legislative call to action surer, and three classes of coun- might ask you to call your congressio- cilors-at-large. The composition nal representatives. A call for abstracts of the Nominating Committee is might direct you to our website. An specified in ourbylaw s (http://www. informational tweet might address work asts.org/TheSociety/MissionByLaws. the ASTS has done to facilitate better aspx)and they are charged to bring reimbursement. Tell us how you think a slate of nominees to the business we should use this new media because meeting each spring for election. we don’t know all the answers and the technological landscape changes quickly. I’m pleased to report that we had Commentary, controversy, news, views – a record turnout at this year’s Dr. Merion presented Dr. Roberts with a plaque and it’s all possible! business meeting at ATC, perhaps gavel and thanked him for his service to the Society as because of John Roberts’ sugges- the 35th President. Is it a gimmick or the next real thing? tion to start the ASTS reception It’s too early to tell, so stay tuned and at the beginning of the meeting! More candidates for all elected positions or stay involved – in my opinion we will than 80 members got to hear the latest just certain ones (like the councilor-at- either embrace new technology or get left ASTS news, participate in discussion of large positions)? behind! important topics, and vote on the slate of proposed candidates for elected positions. I have asked the Executive Committee Is it time for a change in leadership? However, those 80 represent less than to embark on an exploration of these 10% of our membership. That got me important ASTS leadership issues and The American Society of Transplant thinking about ASTS elections. It’s time I am soliciting the opinions of our past Surgeons was established in October, to consider some changes in the process presidents. I also strongly urge you to 1974, when 16 founding members met that may increase participation, encour- contact me, because it is my firm belief in Rockville, MD. Over the next several age leadership diversity, and strengthen that an open, transparent, and inclusive months, 127 surgeons signed up and the our society. Here are a few examples of ASTS is a stronger, more representative, first ASTS Annual Meeting was held in questions to consider: and more responsible ASTS. May 1975 at the Hyatt Regency Hotel in Chicago. • Should the entire membership have With warmest regards, the opportunity to vote via a secure ASTS is now in its 35th year of existence, online system or only those members having grown from humble beginnings to who attend the business meeting? a nationally and internationally respected • Should we have contested elections society, increasing each year in number, with more than one candidate? Bob Merion stature, influence, and areas of service to • If so, should we offer competing our members. The graphic shows the es- pecially remarkable growth of our society over the past few years, and elsewhere ASTS Membership Growth in this issue of the Chimera is a 5-page 1974-2009 ASTS retrospective. 1600 1506 1400 With growth and longevity come 1156 1200 responsibility and maturity. We must 1032 ensure smooth transitions in the society’s 1000 985 leadership each year to highly qualified, 800 enthusiastic, and interested members of the society with strong visions for our 600 586 future and a sense of responsibility to our 400 320 membership. We hope that you view 200 your current Executive Committee and Number of Members 127 0 Council favorably in that light. 1970 1980 1990 2000 2010 www.asts.org Chimera Summer 2009 5 ASTS News The ASTS Spring Council and Committee Chair Meeting was held May 29-30, 2009 in Boston, MA The following are select committee new and reports from the meeting

ABS Re p o r t living donor transplantation by moving interactive online feature that would Dr. Robert Merion reported on behalf of and consolidating existing living donor allow members to create custom cross Dr. James Schulak that the Transplant policies. Meantime, the committee tabulations of the compensation data Advisory Council (TAC) met recently will review the OPTN/UNOS kidney through an Online Searchable Results and continues to agree that ASTS’ goal paired donation pilot program proposal (OSR) function. The council discussed should be to make transplant rotations and provide recommendations. Lastly, options for incentivizing greater partici- the most valuable general surgery rota- guidance (not policy) for the informed pation in the survey and a fee structure. tion/service. The curriculum committee consent of living donors by the OPTN/ developed a resident curriculum consist- UNOS Living Donor Committee was Dr. Abouljoud reported that five Mock ing of 75 online modules as a subset of developed to help transplant profes- Medicare Surveys (MMS) have per- the overall fellowship curriculum. It was sionals develop consent processes for all formed thus far in 2009. The MMS is suggested that a session be held at the living donors and to inform and educate featured in the committee’s new market- winter symposium on how to improve potential living liver donors about their ing brochure and ASTS exhibited at the residency experience from two per- own medical evaluations. the Transplant Management Forum in spectives, those with fellowship training Seattle on April 22-24, 2009 to create programs and those without. Ad Ho c NP/PA Co m m i t t e e greater awareness of the ASTS services Ms. Deborah Hoch reported that there to transplant administrators. The com- Ad Ho c Co m m i t t e e are over 1,700 advanced practice profes- mittee is also currently evaluating the o n Co m p o s i t e Ti s s u e sionals who have identified transplanta- feasibility and opportunity of providing Al l o t r a n s p l a n t a t i o n (CTA) tion as specialty through certification post Medicare audit consulting ser- Dr. Linda Cendales presented the boards. There is no national educational vices to programs who need help with overall goals for the committee, which program for advance practice provid- developing and implementing corrective are to develop guidelines for vascularized ers and standard of care and access to action plans. The committee is working composite tissue allocation and procure- training through ASTS will be of high to develop a dedicated section on the ment, following OPTN/UNOS param- interest to this group. The commit- website created for business practices eters, include CTA in the Scientific tee’s short-term goals are to initiate a services. Finally, Dr. Abouljoud present- Registry of Transplant Recipients national survey to assess the needs of ed the committee’s recommendations (SRTR) and initiate a registry to include physician extenders in transplantation, on the request a to evaluate a business the unique aspects of CTA. In addition, develop an educational program at the opportunity for ASTS to establish a the committee plans to define standards winter symposium, increase membership Donor Call Center but further study and for what a composite tissue program and in the upcoming year and increase chan- analysis is needed. surgeon would constitute. nels of communication. By l a w s Co m m i t t e e Re p o r t Ad Ho c Co m m i t t e e AJT Up d a t e Dr. Stuart Flechner reported that the o n Li v i n g Do n a t i o n Dr. Robert Merion reported that the committee presented options for moving Dr. Andrew Klein reported that the journal is approaching its 10th year and committee appointments as a privilege committee has formulated a response it’s still a thriving journal. Dr. Philip of the president to a more inclusive to the OPTN/UNOS proposed policy Halloran’s term as chief editor is ending approach to appoint committee mem- on Recipient Selection for Organs from in 2010 and ASTS and AST are solicit- bers. A motion was made to change Nondirected Living Donor Allocation of ing applications. Dr. Merion reported that the language in Article 6: Section 2 Nondirected Living Donor Organs. Next, the AJT is moving to increase its online under Committees of the ASTS Bylaws a proposal is circulating to improve the presence and material by providing vid- to place responsibility of nominating safety of living donation through an eos, interviews, and audio content. committee positions under the auspices improved ABO verification process. of the Nominations Committee and Also expected to be circulated is a pro- Bu s i n e s s Pr a c t i c e not the president to provide a broader posal on the Guidance for the Medical Dr. Marwan Abouljoud presented a perspective on these key positions. The Evaluation of Living Liver Donor. Dr. proposal and received council approval motion was defeated with 3 in favor Klein went on to report that the OPTN/ for a 2010 compensation study and and 12 opposed. Subsequently a second UNOS had created a separate OPTN report. The council requested additional motion passed to change internal policy policy section for policies related to information in regards to the proposed to have the Nominations Committee re-

6 Chimera Summer 2009 www.asts.org view committee nominations and make Et h i c s Co m m i t t e e submitted to the OPTN/UNOS. ASTS recommendations for appointments to Dr. Alan Reed reported that the manu- attended the Surgical Quality Alliance the president. script, “Stimulus for : (SQA) meeting. He highlighted three A Survey of the American Society of areas of interest: 1) formulating trans- Ce l l Tr a n s p l a n t Co m m i t t e e Transplant Surgeons Membership” was plant specific performance measures, 2) Dr. Steve Paraskevas reported that a let- accepted for publication in AJT. The SQA plans to roll out patient satisfac- ter was sent to the Secretary of Health committee was asked to take on a com- tion survey and 3) should ASTS join and Human Services highlighting the prehensive review of conflict of interest SQA in approaching payers to discuss ongoing issues with the cost of pancre- policy and disclosure as it relates to risk-adjusted reimbursement? ata used for islet transplantation and its ASTS, ATC and AJT. negative impact on the field. The com- Sc i e n t i f i c St u d i e s Co m m i t t e e mittee will have details of a follow up Fe l l o w s h i p Tr a i n i n g Co m m i t t e e Dr. David Gerber reported that the com- meeting with Dr. Barry Straube, Chief Dr. John Magee presented a Parallel mittee completed the second DonorNet Medical Officer and Director of Clinical Track Position Statement. The council survey in January 2009. A letter sum- Standards Group. Lastly, the commit- approved the statement, which is posted marizing the results was sent to the tee would like to develop a consensus on the website at http://www.asts.org/ OPTN/UNOS in April. The committee conference on islet transplantation at TheSociety/PositionStatements.aspx. Also is moving forward with an analysis of the winter symposium. approved was a proposal to discontinue financial implications of the Medicare the Quality versus Quantity program, regulations with a preliminary focus on Communications Co m m i t t e e which was established as a short-term expenses related to Quality Assurance Dr. James Whiting presented current solution several years ago, as well as a and Performance Improvement (QAPI), web trend statistics and the steady proposal for ASTS to require program donor advocates, increase in personnel incline of visits to the ASTS website in directors to be members of the Society. and frequency of Medicare surveys. the past two years. The infrastructure to establish Real Simple Syndication Dr. Magee also outlined new commit- Va n g u a r d Co m m i t t e e (RSS) Feeds is complete and currently tee efforts to develop a process to review Dr. Randall Sung presented highlights in testing mode for implementation. programs on an annual basis, to develop a of the upcoming ASTS 2010 State Lastly, Dr. Whiting presented future probationary mechanism, to review vol- of the Art Winter Symposium to be developments that include management ume metrics and volume requirements. held at the Harbor Beach Marriott in of and implementing CenterSpan into Ft. Lauderdale, Florida. The theme is the ASTS website, as well as establish- Me m b e r s h i p Co m m i t t e e “The Cutting Edge of Transplantation ing additional means of communicat- Ms. Katrina Crist reported that the Surgery” and the Pre-Meeting will be ing with the members. The council society membership is at 1507 members, “Clinical Research in Transplantation.” requested that the committee develop an increase of 163 from the last quarter. The location for 2011 will be the Westin a user-friendly system for soliciting The ASTS established dual membership Diplomat Hotel in Hollywood, Florida. feedback from the members on ASTS with NATCO and 130 of the new mem- Dr. Sung reported that new in 2010 will position statements and comments on bers fall into this category. A conference be concurrent thoracic and abdominal policy proposals. call with Ms. Cassandra Smith-Fields, sessions and case presentations with Chair of the OPTN/UNOS Transplant audience response incorporated into Cu r r i c u l u m Co m m i t t e e Administrators Committee concluded the program. Dr. Sung also presented a Dr. Elizabeth Pomfret reported that to that the administrators are interested in workforce initiative proposal to enhance date 212 modules have been identified, forming a standalone society to repre- and monitor current databases for the 178 authors have accepted to produce sent their interests or partnering with an purposes of job tracking/manpower, a module and 49 modules are online or existing transplant society. The trans- junior membership, meeting attendance in the queue waiting for approval to be plant administrators plan to conduct and ATC abstract review. The target released to website. Additionally, she a survey to assess member interest and audience to develop a database would advised that 16 of the 75 modules identi- feasibility of a variety of options and be fellows in training, graduating fellows fied as part of the resident curriculum are necessary resources. and junior members. Committee will online. The curriculum has been con- use the ASTS membership database to sistently touted as a cornerstone project St a n d a r d s Co m m i t t e e determine potential participants. The of the ASTS, and it is the lynchpin for Dr. David Mulligan reported that the goal is to have an automated database a number of other important initiatives guidelines for controlled donation that will generate a report of collected including improving resident rota- after cardiac death were submitted data and identify trends over time. tions, maintenance of certification and for publication to the AJT, and that potential focused expertise board exam. the recommended standards for organ ASTS will provide additional resources procurement and recommendations for to propel the curriculum forward. definition of a transplant surgeon were www.asts.org Chimera Summer 2009 7 Regulatory and Reimbursement Update

CMS Is s u e s 2010 Pr o p o s e d surgery decreased from $91 to $81. Me d i c a r e Pr o p o s e d Ho s p i t a l Ph y s i c i a n Fe e Sc h e d u l e The CMS impact analysis estimates In p a t i e n t Pa y m e n t Ru l e f o r 2010 The Centers for Medicare and Medicaid a 4% increase for General Surgery In April, CMS released the proposed Services recently released its 2010 and a 3% decrease for cardiac/tho- hospital inpatient prospective payment proposed physician fee schedule rule racic surgery with at least 1% being system (IPPS) rates for 2010. The 2010 which sets forth proposed payment rates attributable to the new survey results. proposed DRG weights for transplant for 2010. CMS also used the proposal to However, as reflected in the Table on services are set forth in the table below. announce a number of policy changes page 9, all of the transplant codes, Unlike last year, in which CMS pro- which could have an impact on ASTS including heart and heart/lung would posed and subsequently finalized drastic members. They include: increase. reductions to the “uncomplicated” liver and heart DRGs, the proposed DRGs • Implementation of AMA/RUC • Elimination of Consultation Codes and for 2010 are more similar to current Physician Practice Expense Survey: Increase in Other E and M Codes: 2009 rates although both the liver and At CMS’ direction, the AMA, In an effort to increase payment for heart “uncomplicated” DRGs would together with the medical specialties, primary care services, CMS is propos- undergo small reductions. funded and implemented a survey ing to eliminate payment for inpatient on physician practice expenses. This and outpatient consultation codes and Last year’s IPPS rule included several survey, undertaken in 2007-2008, was redistribute the RVUs for those ser- new “hospital-acquired conditions.” designed to replace the outdated CMS vices among the other evaluation and However, CMS is not proposing any survey from 1995 that CMS had been management codes. This, combined new HACs in this year’s proposal. The using in its Physician Fee Schedule with boosts from implementation final IPPS rule will be published around calculation. The survey yielded new of the new survey, results in overall August 1, 2009. practice expense per hours for each increases for Family Medicine and specialty as well as new data on direct Internal Medicine of 8% and 6% CMS Co n s i d e r s Tr a n s p l a n t to indirect cost ratios. The amounts respectively. Ce n t e r App e a l s Ba s e d o n paid for practice expense associated “Mi t i g at i n g Fa c t o r s ” with transplant surgery are comprised • Recalculation of Malpractice RVUs: CMS reports that they have received almost entirely of indirect expenses CMS is proposing a new methodology requests for review based on mitigating since most of the direct costs (e.g. designed to more accurately capture factors from approximately 25 trans- clinical staff, equipment, supplies) are malpractice costs by specialty. CMS plant center programs. Nine of the incurred by the hospital. Transplant estimates the impact of this as a posi- requests (43%) were approved. Seven surgery is assigned to the specialty of tive one percent for General Surgery of the nine were related to patient or general surgery or cardiac/thoracic and positive three percent for cardiac/ outcomes and all seven of those surgery for heart and lung transplants, thoracic Surgery. programs were able to demonstrate for purposes of the Medicare physician substantial program improvements that fee schedule calculations. The general had been implemented and institution- surgery PE/Hr increased from $70 to alized, significant evidence of improved $100; the PE/hr for cardiac/thoracic outcomes subsequent to the changes, and projected compliance with out- 2010 Proposed comes requirements based on current MS-DRG Title 2009 DRG Weight DRG Weight outcomes. Two of the nine approved were related to volume. As part of the Heart Tx or Implant of Heart Assist 23.0701 25.1254 review of a mitigating factor appeal System w/MCC based on outcomes, CMS requires Heart Tx or Implant of Heart Assist 12.815 12.0884 the center to submit graft and patient System w/o MCC survival data for six-month intervals Liver Tx w/MCC or intestinal Tx 10.8180 10.7983 going back three years and may require Liver Transplant w/o MCC 4.8839 4.9885 ongoing submission of data subsequent Lung Tx 8.4002 9.9992 to the filing of the appeal so that it can Simultaneous Kidney/Pancreas Tx 5.1726 5.1271 monitor the center’s improvement. An Pancreas Tx 3.8902 4.3277 effective QAPI program and a thorough Kidney Tx 3.0654 3.0194 root cause analysis were also cited by

8 Chimera Summer 2009 www.asts.org Proposed 2010 Percentage Facility Proposed Change in Change in Total 2010 Facility Facility RVUs Facility Total Total Using 2009 CPT1,3/ Total RVUs, RVUs, Conversion HCPCS Mod Description RVUs 2009-2010 2009-2010 Factor

32851 Lung transplant, single 71.01 1.37 2.0% $2,561.09 32852 Lung transplant with bypass 78.21 1.16 1.5% $2,820.77 32853 Lung transplant, double 84.78 1.45 1.7% $3,057.73 32854 Lung transplant with bypass 92.71 2.11 2.3% $3,343.73 33935 Transplantation, heart/lung 98.34 2.56 2.7% $3,546.79 33945 Transplantation of heart 138.23 12.92 10.3% $4,985.49 47120 Partial removal of liver 64.11 5.81 10.0% $2,312.23 47122 Extensive removal of liver 95.08 8.26 9.5% $3,429.21 47125 Partial removal of liver 85.13 7.36 9.5% $3,070.35 47130 Partial removal of liver 91.29 7.67 9.2% $3,292.52 47135 Transplantation of liver 134.95 11.96 9.7% $4,867.19 47136 Transplantation of liver 115.53 10.64 10.1% $4,166.77 47140 Partial removal, donor liver 98.29 11.37 13.1% $3,544.99 47141 Partial removal, donor liver 107.19 4.10 4.0% $3,865.98 47142 Partial removal, donor liver 129.71 16.41 14.5% $4,678.20 47146 Prep donor liver/venous 9.2 0.63 7.4% $331.81 47147 Prep donor liver/arterial 10.73 0.73 7.3% $386.99 48552 Prep donor pancreas/venous 6.6 0.70 11.9% $238.04 48554 Transpl allograft pancreas 68.68 7.07 11.5% $2,477.05 50320 Remove kidney, living donor 38.67 1.58 4.3% $1,394.70 50327 Prep renal graft/venous 6.04 0.52 9.4% $217.84 50328 Prep renal graft/arterial 5.26 0.41 8.5% $189.71 50329 Prep renal graft/ureteral 4.82 0.03 0.6% $173.84 50340 Removal of kidney 25.58 2.65 11.6% $922.58 50360 Transplantation of kidney 69.9 7.29 11.6% $2,521.06 50365 Transplantation of kidney 78.01 7.44 10.5% $2,813.56 50370 Remove transplanted kidney 32.49 3.25 11.1% $1,171.80 50380 Reimplantation of kidney 54.01 4.62 9.4% $1,947.96

CMS as important in reaching a positive noted that many of the mitigating factor Co s t o f Pa n c r e a t i c Is l e t Ce l l s decision. appeals submitted by transplant centers ASTS has continued to request CMS to related to outcomes reflected a lack of reverse its current policy, which requires CMS still has a number of requests understanding of the SRTR methodol- OPOs to charge the same amount for pending and noted that it may take at ogy and risk adjusters. They stated that pancreata used for islet cell transplanta- least seven months from the time it the most effective appeals were those tion and pancreata used for whole organ receives a request to make a decision. in which the transplant center could transplantation. ASTS recently met The national office is working with its demonstrate prompt identification of with CMS officials again to reiterate regional offices to make sure that any problems and implementation of cor- this request, and CMS currently has the termination processes are put on hold rective action. Attempts to rationalize matter under advisement. pending completion of mitigating factor lower than expected outcomes as due review. to patient or donor risk factors not By Diane Millman, Esq. and captured by the SRTR were generally Rebecca Burke, Esq. ASTS recently met with CMS in the unsuccessful because the patient or graft Powers, Pyles, Sutter and Verville, PC division responsible for transplant deaths that caused the center to fail the ASTS Regulatory Counsel center certification to discuss a number Medicare outcomes test were not those of issues related to the certification the center identified as high risk. process. At the meeting, CMS officials www.asts.org Chimera Summer 2009 9 Legislative Report

Co n g r e s s Pu s h i n g t o Ad v a n c e tively, are known as the Comprehensive He a l t h Re f o r m Bi l l Coverage Five different House and Senate for Kidney Transplant Patients Act of Committees with jurisdiction over 2007. The legislation would eliminate health care and Medicare policy are the 36-month time limit in coverage scheduled to “mark up” legislation in of immunosuppressive drugs for kidney July, constituting the most active month transplant recipients whose Medicare for health care reform in many years. coverage is based solely on their ESRD House Democratic leaders want to push status. This three-year limit on im- the package through the three commit- munosuppressive drug coverage is not a tees of jurisdiction and then through the problem for recipients of organs other full House by early August, when mem- than kidneys due to the unique eligibil- bers leave for the long August recess. ity status that ESRD patients have with Democratic leaders can pretty much set the Medicare program. the pace for House floor action, but the health care package faces a more dif- The transplant community has long ficult path in the Senate. advocated for ESRD kidney recipients to receive coverage of immunosuppres- If the two Senate committees—the sive drugs for the life of the transplant Finance Committee and the Health through Medicare Part B. Under these Education Labor and Pensions (HELP) wealth where the middle class will lose. bills, transplant recipients would pay the Committee—complete their separate Proponents counter that the health care Part B premium, and Medicare would versions of the legislation before the system in America is unsustainable, too be extended beyond 36 months only for August recess, they will face another costly, and is only working for some. recipients who lack other health care hurdle that is just as substantial—decid- From a purely structural point, the out- coverage. All other health care needs ing how to combine their bills on the lines for the bills are largely the same — for transplant recipients who are not floor in a way that generates maximum but some of the policies differ. Democrats Medicare aged or disabled would remain support. To capture as many votes as still have not reached agreement on such subject to the current ESRD 36-month possible, the Finance Committee is aim- issues as the inclusion of a government- coverage limit. Only immunosuppressive ing for a politically moderate measure in run “public plan” option for insurance, or drugs would be covered for the life of the order to attract Republican support. The the contributions businesses will be asked transplant under this legislation. These Health, Education, Labor and Pensions to make in the form of employer man- limitations were necessary to reduce the (HELP) Committee is pursuing a more dates. Still unsettled is the question of cost of the legislation and breathed new liberal—and more partisan—package. whether individuals’ health care benefits life into a bill that has been reintroduced Many do not expect a conference report from their employers will be taxed as a several times in successive Congresses and a final vote on health care reform mechanism to pay for a large expansion without action being taken. before the end of the year. Keeping of insurance coverage to people who are to this timeline is the subject of much currently uninsured. In fact, in the last Congress, the im- speculation as negotiations grind on. munosuppressive drug extension bill was Im m u n o s u pp r e s s i v e Dr u g estimated to cost approximately $1 bil- President Obama highlighted what “Co v e r a g e Ex t e n s i o n ” lion over ten years. However, earlier this is perhaps his biggest challenge in Le g i s l at i o n year, the Congressional Budget Office maintaining support for remaking the ASTS has continued its long-standing (CBO) estimated the ten-year cost of this health care system. That is to make work this year on one of its signature provision at $800 million, largely due sure Americans do not think they will priorities; extension of immunosup- to recalculations in the CBO’s assump- personally lose out in an overhaul of pressive drug coverage for Medicare tions. ASTS believes that arguments it the way medical services are delivered beneficiaries. Working in concert with has advanced have contributed to this – through higher costs to themselves, other transplant organizations, ASTS lower score, namely, that Medicare saves lower quality of care or simple inability has taken a lead role in successfully dialysis costs and retransplantation costs to get the care they need. Opponents’ including this issue in the health care when beneficiaries increase their chances talking points are clear: The Congress is reform debate. The House and Senate of keeping their graft due to better drug embarking on a massive redistribution of bills, H.R. 1458 and S. 565, respec- compliance. In early July, the CBO

10 Chimera Summer 2009 www.asts.org recalculated this provision again, lower- by 21 percent in 2010 unless Congress as possible for the DoT account within ing the ten-year cost to just $400 million. intervenes. The new payment update in the Labor, Health & Human Resources This is largely due to the fact that other 2010 would be based on the Medicare Appropriations Subcommittee bill for FY provisions in the House bill related to Economic Index and the provision 2010. ESRD care are having a material impact would give CMS a year to implement on the cost of this provision. the new payment system. Beginning in In s u r a n c e Co v e r a g e f o r Or g a n 2011, the new system would allow the Do n o r s With strong, consistent advocacy from volume of most services to grow at the Since 2008, ASTS has been promot- ASTS and a number of transplant- rate of GDP plus 1 percentage point per ing legislation the requires the federal related organizations known as the year and allow the volume of primary government to prohibit private health Immunosuppressive Drug Coalition, and preventive care services to grow insurers and self-insured health plans ASTS learned at the end of June that at GDP plus 2 percent per year. The from treating live organ donors as having our efforts to secure inclusion of this new payment system would also ex- a pre-existing condition. These pre- bill in the House health care reform bill clude prescription drugs and laboratory existing condition exclusions dramati- succeeded when the bill was included services from the payment calculation. cally increase the cost of health insurance in Section 1232 of the House Tri- The CBO estimates that this long-term for altruistic donors or have the impact Committee draft health care reform bill. payment formula fix would cost approxi- of rendering the person uninsurable The bill is to be considered in House mately $229 billion over ten years. altogether. Private insurance plans often mark-up hearings the week of July 13th treat an individual’s donor status as a pre- with final passage in the House expected Or g a n Do n a t i o n Ac t Fu n d i n g existing condition thus creating a serious at the end of July or early August. At the end of last year, the Society disincentive for living donation. ASTS is now focused on securing along with other members of the this legislation in the Senate Finance Transplant Roundtable and congres- The House bill would change this prac- Committee health reform package sional allies succeeded in securing a tice, not just for organ donors but for all which is also expected to be considered $1.4 million increase for FY 2009 to the treatments considered pre-existing con- the week of July 13th. In addition to organ donation and transplantation pro- ditions through the “Health Insurance the efforts of the Society’s federal staff, grams of the Division of Transplantation Exchange” provisions by prohibiting many of the ASTS leadership, including (DoT) within the Health Resources and discrimination against any patient based President Robert Merion, MD, as well as Services Administration (HRSA). This on their health status. Such a change members of the Legislative Committee, funding began as a non-binding $5 mil- would remove a huge impediment for have personally reached out to their lion amendment to increase the federal organ donors and transplant recipients Senators and Members of Congress seek- budget championed by our long-time who otherwise would be denied access ing their support for including these bills ally Senator Dorgan (D-ND). through their insurance coverage or in the final health reform package to be would be “priced out” of being able to passed this year. This year, Senator Dorgan doubled his re- afford insurance coverage. If compre- quest and secured a $10 million increase hensive reform is not achievable this Fi x i n g t h e Me d i c a r e Ph y s i c i a n to the Division of Transplantation (DoT) year, ASTS will continue to advocate Pa y m e n t Fo r m u l a in the FY 2010 federal budget for these for the establishment of a more specific On physician payment, the House programs. The allocations in the federal prohibition on insurers that treat live Tri-Committee bill would adopt a budget in turn determine the overall organ donation as having pre-existing policy that would scrap the current way spending allocations in the various condition exclusion for purposes of Medicare pays physicians and replace it federal appropriations bills. Again, the obtaining private health insurance. with a system allowing pay increases for $10 million increase is non-binding and most services to be based on the growth simply helps ASTS and others advocate By Peter W. Thomas, in the gross domestic product. Under for increases in appropriations levels later ASTS Legislative Counsel, current law, doctors’ Medicare reim- in the year. ASTS is working hard to se- Adam R. Chrisney, Legislative Director bursement is scheduled to be reduced cure as much of the Dorgan amendment Powers, Pyles, Sutter & Verville, PC

Visit the ASTS website for additional advocacy efforts at www.asts.org /Advocacy

www.asts.org Chimera Summer 2009 11 OPTN/UNOS Corner

OPTN We b Si t e Tr a n s i t i o n to liver allocation policy. The test kit used to assess potential a n d Im p r o v e m e n t s need for additional discussion was organ donors for HTLV 1 and The and prompted in part by a recent pub- 2 prior to donation, the Board Transplantation Network (OPTN) has lic comment proposal to allocate resolved that the OPTN end changed its address and improved its all throughout the OPTN the requirement of prospec- web site. The new site can now be found region based on MELD/PELD tive HTLV testing for deceased at http://optn.transplant.hrsa.gov. score instead of the current tiered donors, effective pending notice Although the www.optn.org address will local/regional sequence. Based on to members. The Board fur- include a redirect to the new site, we significant concerns raised during ther specified that retrospective encourage you to check your links and public comment, the proposal was testing with confirmation shall bookmarks. not presented for Board consider- be performed on all deceased The site’s design was updated to coor- ation at this time. donors. Implementation of this dinate with the Health Resources and • The Board endorsed the concept requirement will be delayed to Services Administration’s (HRSA) of incorporating into the Lung permit a minimum 45-day public family of Web sites. The information Allocation Score (LAS), which comment period and review by contained on the site is also compliant prioritizes candidates for lung the OPTN/UNOS Executive with federal Section 508 requirements transplantation, each lung candi- Committee. The OPTN/UNOS for greater accessibility by people with date’s laboratory measure of total Ad Hoc Disease Transmission disabilities. bilirubin and whether candidates Advisory Committee will submit in Diagnosis Group B have a further policy modifications for OPTN/UNOS Bo a r d o f bilirubin score that has increased public comment in late summer/ Di r e c t o r s Me e t i n g Hi g h l i g h t s by 50 percent within a six-month early fall. The OPTN/UNOS Board of Directors period. Data analysis suggests this met June 22-23 in Richmond, Va. It addition would reduce waitlist Ki d n e y Pa i r e d Do n a t i o n Pi l o t took action on a number of items, of mortality primarily among Group Pr o g r a m which key topics are outlined below. B candidates, most of whom need A selection group drawn from the An executive summary of all Board ac- a transplant due to pulmonary OPTN/UNOS Kidney Transplantation tions is available on the OPTN web site. hypertension. To further as- Committee, the Kidney Paired • The Board adopted a policy to sess how this concept should be Donation (KPD) Work Group and broaden access to donated livers implemented and the priority OPTN/UNOS leadership is review- for Status 1A and 1B liver can- of programming, the Board will ing responses to a recent request for didates. At any given moment, consider implementation options proposals for programs to participate in there are usually fewer than 10 at a later meeting. In the interim, an initial implementation of a national of these candidates nationwide. the Board endorsed measures to KPD pilot program. The initial imple- Liver offers from adult donors educate lung transplant centers mentation is meant to help UNOS staff will be considered for any medi- about the process they may use to gain experience with KPD before rolling cally compatible Status 1A and seek additional priority through out a full system in the fourth quarter of 1B candidates throughout the the national lung review board 2010, to test the KPD business processes OPTN region of the donor before for candidates with pulmonary before they are programmed in the full being offered to any less urgent hypertension. system, and to implement a limited patients either locally or region- • The Board additionally ap- KPD system on an expedited timeframe. ally. Experience gained in three proved establishment of a section Due to resource limitations, initial regions that have allocated livers of OPTN policy specifically to implementation is expected to be region-wide, for Status 1A/1B house living donation require- limited to two to four programs or candidates through Board- ments. This new policy section groups. Additional programs will have approved alternate allocation distinguishes current living donor the opportunity to participate in the full systems, some since 1990, was an policies from others meant only to implementation of the KPD pilot pro- important factor in the decision apply to deceased donor transplan- gram anticipated to begin in late 2010. to institute a national policy. tation and will be the destination • The Board endorsed a public for additional living donor policies By Joel Newman forum to be convened in the as they are developed. Assistant Director of Communications spring of 2010 to discuss addi- • Given the announced discon- UNOS tional potential improvements tinuance of the most common

12 Chimera Summer 2009 www.asts.org National Living National Living Donor Assistance Center Update Donor Reducing the financial disincentives to living organ donation Assistance Center

• NLDAC Eligibility Guidelines  Amended – to keep NLDAC in line with the OPTN policies of a 2-year follow up, NLDAC is now allowed to pay for the medi- cal follow-up trip if it is within two calendar years following the living donor procedure, or beyond if certain exceptional circum- stances exists. The original guidelines required the medical follow-up trip to be within 90 days of the surgical procedure. This will allow more donors to see their physicians at their Transplant Centers. Please keep in mind NLDAC pays for follow-up trips only if the application is approved and funded prior to the surgical procedure. • More Applications Received - NLDAC has seen a steady increase in applications submitted. As of June 2009, NLDAC had processed 633 applications and approved 544 (86%). • More Funding Approved - As of June 2009, NLDAC had approved approximately $1.3 million dollars for donor travel. • NLDAC Team Expands - Our newest member, Iby Diaz, brings experience in the administrative and systems fields and her bilingual skills streamline communication with Spanish speaking donors. • Donors Rate NLDAC High - On a scale of 1-5 (5 being the highest), donors rated their experience with NLDAC at 4.6, which reflects a high level of satisfaction. • Ready to Train More Transplant Centers - NLDAC is prepared to receive more applications and strongly encourages Transplant Centers to look for opportunities to help eligible donors with travel expenses. Approximately 53% of Transplant Centers with living donor programs have filed a NLDAC application. Call 703-414-1600 or [email protected] g to set up a one-on-one training in the application process.

Ac a d e m i c Un i v e r s e ASTS members are encouraged to visit tors and chemokines and their role in of the Hippocratic Oath, the talk delves the ASTS Academic Universe and take transplantation. into principles specific to solid organ advantage of the educational resources Unit 2 – Pharmacology and transplantation. available within the online curriculum. : Dr. Richard Modules are continually added to the Simply sign-in to the members’ portal at Knight discusses Maintenance website so check back often for new www.asts.org and click on the Academic Immunosuppressive Agents and provides content and please use the “Feedback” Universe link to access the online cur- an overview of calcineurin inhibitors, function within each module to let us riculum, surgical logs and usage reports. mTOR inhibitors, anti-metabolites and know how we can enhance this educa- While targeted to fellows, the online corticosteroids in a manner fellows can tional tool. curriculum is a dynamic reference for easily grasp. all ASTS members. ASTS is grateful Unit 3 – Organ Procurement: Dr. to all the authors - both members and Michael Ishitani’s module titled Please Note... non-members - that have contributed “Understanding the Moral, Ethical, and their time and expertise to this project. Legal Issues of Death: The Justification New for 2010! Abstracts accepted for The online curriculum consists of eleven for Use of Organs from Deceased and oral, mini-oral or poster presentation units, including organ specific transplanta- Non-Heart-Beating Donors,” addresses at the ASTS 10th Annual State of the tion, , procurement, alloca- the evolution of transplantation and the Art Winter Symposium will be pub- tion, ethics and economics of transplan- concept of death. lished in a special supplement to the tation, and will eventually house 200 Unit 6 – : Dr. American Journal of Transplantation learning modules. Login today to view Christopher Hughes discusses DCD liver (AJT) to be shipped with the January these and other modules: transplant outcomes and provides data issue. Please visit www.asts.org for Unit 1 – Immunobiology and from numerous recently published studies. more information or to submit an Transplantation Research: Dr. Jonathan Unit 10 – Ethics: The module au- abstract. The deadline to submit an Bromberg’s presentation on inflam- thored by Drs. Peter Angelos and Eric abstract is Wednesday, September 9, mation and innate immunity in organ Grossman serves as an analysis of cur- 2009 and notification will be sent in transplantation discusses topics such as rent ethical issues in the field of trans- mid-October. ischemia/reperfusion, toll like recep- plantation. After discussing the origins www.asts.org Chimera Summer 2009 13 35th ASTS Celebrates 35 Years Anniversary Those Early Years

he American Society of Trans- By definition, our principal Lee went on to explain how this was plant Surgeons was founded in advice he lived by when asked about the T1974 in an effort to unite surgeons objectives are therefore formative years of ASTS and transplan- involved in transplantation. The effort intellectual and tation: Everybody’s experience was small; was spearheaded by Drs. Frederick Merkel always somebody had a new finding. It was and John Bergen from Northwestern professional and this must exchanging, I had this kind of problem, and University and Dr. Aaron Bannett from be reflected in the programs this kind of complication and the other one Albert Einstein Medical Center. The [surgeon] would learn from that. It was idea to form a national society grew from we develop annually…the much more intimate; there was a very per- a meeting originally convened by the name, Society of sonal communications exchange. Department of Health, Education and Transplant Surgeons, is Welfare to obtain input from transplant Two other charter members reminisced surgeons concerning the Social Security all-inclusive. It would be about the basic principles of transplan- Act of 1972. This act, later signed into both tragic and inexcusable tation and offered these thoughts: law, established the End-Stage Renal Dis- ease (ERSD) Program. if we functioned as a Well I just think that transplantation is such society for kidney a wonderful field because it covers so many In that same year, another meeting transplantation [only]. different areas. Mentorship is important, brought together 16 surgeons in Chi- teaching is important, we need to continue cago. During that meeting, the name this. – Dr. Frederick Merkel, 5th ASTS of the society and requirements for Today, members of ASTS specialize in President and Founding Member membership were discussed. The general lung, heart, kidney, liver, pancreas/islet belief of the Society was that transplan- cell and intestine transplantation, as well I think transplantation has done a wonder- tation would become much more impor- as composite tissue . ful job and the society has done a wonderful tant for patients with end-stage diseases job. The science…has improved tremen- of a variety of organs, rather than kidney Over the last twenty years, the Society dously, the education has become more for- alone. has established a strong presence in malized, and the communication within the transplantation research, education and system has become more formalized. – Dr. Subsequently, 127 Charter Members training, and advocacy. These basic James Cerilli, 7th ASTS President joined the Society; nineteen of whom principles remain the pillars that the Dr. William Pfaff, an ASTS Charter have served as ASTS President. Dr. Society stands upon: to foster and ad- member, recalls his experience as a Thomas Starzl was elected as the Soci- vance the practice and science of trans- transplant surgeon: ety’s first President and presided over the plantation for the benefit of patients and First Annual Meeting, held at the Hyatt society; to guide those who make policy The impact of transplantation has been im- Regency Hotel in Chicago, Illinois, decisions that influence the practice and mense. It’s the best decision I’ve ever made. May 23, 1975. science of transplantation; to define and I’ve had more fun learning, doing and promote the training and career-long proving sometimes, really achieving, and I In Starzl’s inaugural speech, he said, You education of its members; and to ad- particularly enjoyed my roles in the organi- cannot shrink from a clear enunciation of vance the professional development and zations that relate to transplantation. our first priorities. My own bias is simple. I careers of its members. think that we [transplant surgeons] exist for It is these and other charter members the development and exchange of accurate During a 2009 interview, Dr. H. M. Lee, that helped pave the way for not only information and informed opinion. By defini- ASTS 11th president, was asked what ASTS members but the entire trans- tion, our principal objectives are therefore advice he could offer younger transplant plant community. Today, the American intellectual and professional and this must surgeons as the field expands. Lee an- Society of Transplant Surgeons’ mem- be reflected in the programs we develop an- swered, Personal, intimate exchange of the bership includes over 1500 transplant nually…the name, Society of Transplant transplant experience, whether good or bad, surgeons, physicians, scientists, and al- Surgeons, is all-inclusive. It would be both will be conducive to the future development lied health professionals from all around tragic and inexcusable if we functioned as of more experimental and additional clinical the globe. a society for kidney transplantation [only]. transplants.

14 Chimera Summer 2009 www.asts.org th ASTS Celebrates 35 Years 35 The ASTS Now Anniversary Thomas G. Peters, MD, FACS, ASTS Historian

he first Annual Meeting of the – our patients. Thus, the mission, written continue to tell the story of transplanta- American Society of Transplant so well in 1974, remains. tion as it once was. Many of these pio- TSurgeons (ASTS) was held May neers are still productive, and continue 23, 1975, at the Hyatt Regency Hotel Today, 6 officers and 9 Councilors-at- to guide us. Still despite maturation, we in Chicago. A scientific session and a Large lead the ASTS. Additionally, remain small as compared with many lively business meeting ensued at which there are twenty-three standing com- other surgical specialty societies. Our a number of issues were raised. Among mittees and eight task force groups relatively small size, however, should these were the selection of the journal, and/or ad hoc committees on topics not ever deter us from the important Surgery, for publication of the present- ranging from awards to journal manage- elements of our professional and public ed papers, transplant education, public ment to legislation and even practice duties to comment on all matters related relations, and criteria for the 127 mem- standards. ASTS groups have embraced to organ and tissue transplantation. bers of this new Society. There was no new areas as times have changed. An ASTS office or staff, and administrative example is our Critical Care Task Force Finally, no update on the Society would tasks were managed through individual currently examining how transplant be complete without a comment about efforts of the respective officers and surgeons ought to fit into treatment our staff. Led by Executive Director, committee chairs. venues where transplant recipients Katrina Crist, MBA, the ASTS office require intensive care. Tasks of our Ad now employs, in conjunction with How we have grown! Now, with over Hoc Committee on Living Donation the National Living Donor Assistance fifteen hundred members and an agenda, have evolved recently with the issues of Center, eight persons, all capable which reaches far and wide, our ASTS living donor swap or domino donation- professionals, who carry out the day- is the voice of transplantation surgeons transplantation as well as the important to-day functions of our society. These in North America and, to a large degree, matters of costs and outcomes affecting professionals are committed to our the world. Interestingly, the basic any living donor. Multiply critical care mission, and facilitate the realization of mission of the ASTS has not changed and living donation topics by as many all the ideas, plans, and aspirations of since its inception. The purposes of the transplant issues as one might imagine, your ASTS leadership and your fellow ASTS are to, “encourage education and and there emerges some idea as to the members. research with respect to organ and tissue very busy agenda of the ASTS Council transplantation,” and to, “collaborate and its Committee Chairs. Said simply, the ASTS now is the with existing public and private organi- premier resource for transplant surgeons zations to promote…optimal benefit to Visit our website. Even for nonmem- and for virtually all information about recipients of transplants.” These words, bers, the website gives a thorough our discipline. Surgical curriculum and virtually unchanged since our inception, and easily used summary of a modern standards, the American Transplant have guided the organization through ASTS. Legislative accomplishments, Congress and our ASTS Winter three and one-half decades. The com- education issues, and information about Symposium, business practices and reim- parison of the mission, then and now, living donor assistance programs are all bursement for our clinical tasks, liaison belies a substantial contrast: the Society there. For members, the overview of with the American Board of Surgery has evolved from simple origins to its meetings, advocacy, awards, training, and the American College of Surgeons, current broad and dynamic structure. membership, and other matters is truly and so many more matters are before our complete. In addition, we have our own ASTS leadership every day. Moreover, Imagine if you will, our Society with- ASTS Foundation, established in 2001, the leaders with our staff have command out its principal journal, The American to support the mission of the ASTS. of these issues while they work effective- Journal of Transplantation. Consider, also, The foundation has been integral in the ly on behalf of ASTS members. With an ASTS, which could not address im- evolution and support of the Chimera over thirty-five years of achievement, portant legislative, work force, reimburse- Chronicles, the stories of our founders over fifteen hundred members, and ment, and philanthropic topics. None and senior members, currently in devel- great success from efforts by all of us to of these matters was prominent in the opment by ASTS. provide maximal efficiency and optimal early deliberations of our founders. Yet, benefit to our patients, the recipients of the ASTS is now immersed in these and So here we are now, a mature and organ transplants. other matters germane to our practices, diverse society which has grown from professional lives, and – most importantly the ideas and efforts of our mentors who www.asts.org Chimera Summer 2009 15 35th Charter Members of ASTS Anniversary Listed below are charter members who joined ASTS in 1974, and are still members today, along with their institutional affiliation at that time.

J. Wesley Alexander, MD Jay C. Fish, MD Anthony P. Monaco, MD University of Cincinnati University of Texas, Galveston New England Deaconess, Boston

Charles B. Anderson, MD D.T. Freier, MD John S. Najarian, MD Washington University, St. Louis University of Michigan, Kalamazoo University of Minnesota, Minneapolis

J.B. Aust, MD, PhD Joseph R. Gerbasi, MD William W. Pfaff, MD University of Texas State University of New York, Buffalo University of Florida, Gainesville

Aaron D. Bannett, MD Mark A. Hardy, MD Howard M. Radwin, MD Albert Einstein Hospital, Philadelphia Albert Einstein, New York University of Texas, San Antonio

Clyde F. Barker, MD J. Laurance Hill, MD JC Rosenberg, MD University of Pennsylvania University of Chicago Wayne State University, Detroit

Khalid M.H. Butt, MD Barry D. Kahan, PhD, MD Gilbert Ross, Jr., MD Downstate Medical Center, Brooklyn Northwestern University, Chicago University of Missouri, Columbia

Clive O. Callender, MD John W. Konnak, MD Oscar Salvatierra, Jr., MD Freedmen’s Hospital, Washington, DC University of Michigan, Kalamazoo University of California, San Francisco

James Cerilli, MD Kenneth A. Kropp, MD William V. Sharp, MD Ohio State University, Columbus Medical College of Ohio, Toledo Akron City Hospital

Abraham T.K. Cockett, MD Hyung Mo Lee, MD Richard L. Simmons, MD University of Rochester Medical College of Virginia, Richmond University of Minnesota, Minneapolis

James E. Colberg, MD Neil Lempert, MD Frank P. Stuart, MD University of California, Irvine Albany Medical College University of Chicago

A. Benedict Cosimi, MD John Libertino, MD William T. Stubenbord, MD Massachusetts General Hospital, Boston Lahey Clinic, Burlington Cornell University, New York

Charles B. Currier, Jr., MD Jimmy A. Light, MD Vivian A. Tellis, MD Washington Hospital Center, Walter Reed General Hospital, Montefiore Hospital, New York Washington, DC Washington, DC Jeremiah G. Turcotte, MD Fuad J. Dagher, MD Robert McCabe, MD University of Michigan, Ann Arbor University of Maryland, Baltimore Columbia University, New York B.A. VanderWerf, MD Edward A. Dainko, MD John C. McDonald, MD University of Miami San Bernardino County Hospital Tulane University, Louisiana John C. Whitsell, II, MD Dennis R. Filippone, MD Frederick K. Merkel, MD Cornell University, New York St. Barnabas Medical Center, Livingston Presbyterian-St. Luke’s, Chicago G. Melville Williams, MD Casimir F. Firlit, MD Joshua Miller, MD Johns Hopkins University, Baltimore Children’s Memorial-Chicago VA Hospital, Minneapolis Clarence E. Zimmerman, MD Beth Israel Hospital, Boston

16 Chimera Summer 2009 www.asts.org 35th At The Helm! Anniversary ASTS Presidents 1974-Present

1. Thomas Starzl 2. Folkert Belzer 3. Thomas 4. John Najarian 5. Frederick Merkel 6. Jeremiah Turcotte Marchioro

7. James Cerilli 8. Richard Simmons 9. G. Melville 10. Oscar Salvatierra 11. H.M. Lee 12. Anthony Williams Monaco

13. Robert Corry 14. John McDonald 15. J. Wesley 16. Barry Kahan 17. David Sutherland 18. Arnold Diethelm Alexander

19. Clyde Barker 20. Frank Stuart 21. Mark Hardy 22. Nicholas Tilney 23. Hans Sollinger 24. Ronald Ferguson

25. Joshua Miller 26. Ronald Busuttil 27. Nancy Ascher 28. Marc Lorber 29. James Schulak 30. Abraham Shaked

31. Richard Howard 32. Benedict Cosimi 33. Arthur Matas 34. Goran Klintmalm 35. John Roberts 36. Robert Merion www.asts.org Chimera Summer 2009 17 ASTS 10th Annual State of the Art Winter Symposium Call For Abstracts

The Cutting Edge Of Transplant Surgery Pre-Meeting: Clinical Research in Transplantation Committed to Leading the Way in the 21st Century

The American Society of Transplant Surgeons (ASTS) invites abstracts to be submitted for the 10th Annual State of the Art Winter Symposium

Important Dates Abstracts Harbor Beach Marriott Online Submission Available Monday, June 29, 2009 Ft. Lauderdale, FL Abstract & Surgical Video Deadline Wednesday, September 9, 2009 Abstract & Video Notification Thursday, November 19, 2009 January 15 – 17, 2010 www.asts.org Pre-Registration and Housing Online Housing Available Monday, August 3, 2009 Housing Deadline Wednesday, December 16, 2009 Pre-Registration Deadline Wednesday, January 6, 2010 ASTS 10th Annual State of the Art Winter Symposium Call For Abstracts Chimera Chronicles Great Stories in Transplantation

In 1974, scientific scholarship, commitment to education and concern for the welfare of transplant patients bonded a growing group of surgeons. Today, ASTS remembers their efforts and share their trials and triumphs. Join ASTS as we celebrate living legacies, pioneers sharing their great stories in transplant surgery.

The first phase of the ASTS Chimera Chronicles Project is complete. On the ASTS website, www. asts.org, wherever you see the icon to the left, click on and explore the history of ASTS and trans- plantation as senior members share their experiences. This historical journey begins with many of the Societies first leaders such as Drs. Thomas Starzl, G. Melville Williams, Frederick Merkel, Oscar Salvatierra, Thomas Fitts and a dozen more. The Chronicles project is complete with member ac- Chimera counts of transplantation as they remember it, their profiles, the full transcript of their interviews, Chronicles a photo library of recent ASTS meetings, details of the ASTS history, and information about the and Foundation of the ASTS. As the years go by, ASTS will continue to work to compile members’ stories ASTS Newsletter and make them available via video streaming and various other media outlets.

ASTS Hi s t o r i a n Re p o r t

Historian Update: The 2009 ASTS Winter Symposium provided a great opportunity to enrich the Society with more personal accounts of our history by past luminaries in transplantation. The Chimera Chronicles project, in which we interviewwww.asts.org senior transplant surgeons, engaged past presidents of the ASTS including Drs. James Cerilli,Chimera John Summer Najarian, 2009 19 H.M. Lee, Richard Simmons, and Arnold Diethelm. A past president of both the Southeastern Organ Procurement Foundation and the United Network for Organ Sharing, Dr. William Pfaff, was also a participant. These Chimera Chronicles video tapes are in the editing process and will soon be available on our ASTS website, as well as excerpts of past interviews featuring Dr. .

We plan to hold the next series of interviews for Chimera Chronicles Mistaken Identity... at the 2010 ASTS Winter Symposium. All interested ASTS members may submit names of prominent transplantation surgeons who may In the Spring 2009 Chimera, we featured a have an interesting story to tell. We ask that interesting stories, papers, Chimera Chronicles tribute. We apologize for documents, or other memorabilia be sent to the ASTS office, atten- the two incorrectly placed names. The cap- tions should have read: tion ASTS Historian. I am available at anytime by e-mail tgpetersmd@ hotmail.com or phone 904 244.9800 should anyone want to discuss interesting aspects of the history of our society and our specialty.

Thomas G. Peters, MD, FACS ASTS Historian

Richard Simmons, MD Arnold Diethelm, MD

www.asts.org Chimera Summer 2009 19 American Transplant Congress 9th Annual Joint Scientific Meeting ATC, A joint collaboration of the ASTS and AST, was held in Boston, May 30 – June 3, 2009

A Global Success! It could have been and regulatory issues related to solid the baked beans, the cream pie or organ and tissue transplantation. the baseball that brought 4265 (not including exhibitors) people from all Pre-meeting symposia addresses topics walks of the world to the 9th Annual that appeal to specialists in the field. American Transplant Congress (ATC), Sunrise symposia are single topic but we’re certain the science played symposia for those searching for targeted a major role. Final registration num- material. bers illustrate that the meeting was Early morning workshop sessions are representative of attendees from 74 smaller and provide better networking ASTS Annual Business Meeting countries. The top five countries in de- opportunities. scending order were the United States, Exhibits, abstracts, and posters are an Following the business meeting, a recep- Canada, United Kingdom, Germany, integral part of the educational experi- tion took place to honor and thank the and France. ence and feature the latest technology ASTS corporate supporters for their and research. commitment to ensuring ASTS has the There is certainly something to be said ATC Today was a daily newspaper pub- resources required to serve the trans- for the science at ATC. The meeting lished specially for attendees. The paper plant community. The ASTS corporate is capturing the attention of more and highlighted special sessions and provides supporters are responsible for numerous more surgeons, physicians, scientists, local information related to the meeting successful projects such as the growth and others seeking to advance and bet- location. and stability of ASTS research awards ter understand the field. Of 2547 ab- programs and educational resources stracts submitted, 1963 were accepted. If you missed this year’s congress, next such as the videos that discuss the risks At over 75%, the 2009 acceptance rate year promises to be just as rewarding. and benefits of organ donation and was higher than the 2008 acceptance Plan to attend ATC 2010 in sunny transplantation. Another project, the rate of 73%. San Diego, CA, May 1-5th, at the San annual fellows’ symposium provides an Diego Convention Center. Abstract additional venue for fellows to partici- 2009 ATC Abstracts submission deadline for ATC 2010 is pate in a series of lectures and interac- Number of Plenary – 20 December 4, 2009. Visit www.atc.meet- tive sessions, to ask questions and fill Number of Concurrent Oral – 644 ing.org for details. the gaps that too often are not covered Number of Posters – 1299 as part of clinical training. Total accepted – 1963 In honor of the leadership, member- Total Abstracts Submitted – 2547 ship, and corporate supporters, this year ASTS hosted a trio of events on June ATC, Something for Everyone 2nd , which began with the ASTS annu- The purpose of ATC is to provide a al business meeting. ASTS is delighted forum for exchange of new scientific that members are 1) taking advantage of and clinical information relevant to the benefits of being an ASTS member, solid organ and tissue transplantation. 2) showing continued interests in the In addition, to create an arena for the Society and its growth, and 3) partici- interchange of ideas regarding care and pating in various society initiatives and management of organ and tissue trans- training programs that serve to advance plant receipt, and lastly to facilitate the field. discussions of socioeconomic, ethical, Corporate Support & Members Reception

We would like to thank the following: ATC Program Planning Committee on another successful year ASTS Corporate Sponsors for their generous support in 2009 ASTS Council and Committee chairs for leadership and dedication to the Society

20 Chimera Summer 2009 www.asts.org 35th President at the annual president’s dinner and presidential speech. Both events are a reflection of the impact ASTS has on the field.

Overlooking the city of Boston, the presi- dent’s dinner took place at The Top of the Hub, Skywalk in the Prudential Center. Dinner began with melodic jazz sounds, Fellows Reception followed by dinner, and a roast if you will, Dr. Roberts, Presidential Speech to Dr. Roberts. Guests shared great laughs The evening ended with a reception for and lauded Dr. Roberts for his dedication greatest number. We should take the same members that provided an opportunity to transplantation, his 20 years at the actions as would a disinterested party and for members to interact one-on-one University of California, San Francisco finally we should only create policies that with colleagues and to learn more about and his contributions to ASTS. we would feel comfortable explaining on the Society and how it exists to serve a national news program.” the interests of the membership. Dr. Roberts’ presidential speech though presented a different tone for transplanta- ASTS has long demonstrated its com- tion, that of simplicity, yet profound. The mitment to training and advancing the focus of his speech was the effects the professional development and careers media has on transplantation. He said “we of its members. We strive to provide av- [the transplant community] need to take enues where members can interact with a broader view of the media and under- collegues. This year, ASTS held a Fellows stand its value to transplantation. Media Reception during ATC to help foster coverage of sentinel events can change and generate mentorship opportunities the attitudes of the public.” After several among the senior and junior members, examples of triumphant media coverage and to spawn additional ideas for com- and the too often scrutinized events, Dr. munications among the membership. Roberts ended his speech by saying “The transplant community will have its own Presidential Highlights crisis as the media focuses its attention Dr. Roberts enjoying a moment with One of the highlights of every ATC is on our failures to distribute organs fairly. mentor John Najarian, MD the tribute to the president. His family, In the future, our policies must pass basic close friends and other society luminar- tests. We should act in a way that we ies joined Dr. John P. Roberts, the ASTS would expect others to act toward us. Plan Ahead We should do the greatest good for the for ATC 2010!

San Diego, CA, May 1-5 San Diego ConventionCenter.

Abstract submission deadline Dr. Roberts with his family at the President’s for ATC 2010 is Dinner, L-R, Donald Roberts, MD (brother), Dr. Roberts center with his wife, December 4, 2009. John D. Roberts, PhD (father), Allen Roberts Nancy Ascher, MD, PhD, (also past presi- (brother) and center, Edith Roberts (mother) dent of ASTS) & Becky, their daughter. www.asts.org Chimera Summer 2009 21 ASTS Research Go For Gold... Awards Recipients ASTS – Roche Pioneer Award The ASTS-Roche Pioneer award is the most distin- guished award bestowed upon an individual by the ASTS ASTS for a significant contribution to the field of transplantation. Visit www.asts.org/awards for a full biographical overview of Sir Roy. Research Sir Roy Calne Cambridge University Awards

Faculty Awards Resident/Trainee Awards Fellowship Awards

ASTS-Astellas Faculty ASTS-Wyeth Collaborative ASTS Wyeth Mid-level ASTS-Team Donate Life Award Scientist Award Faculty Development Award Joshua Mezrich, MD Allan Kirk, MD, PhD Award Michael Hughes, Jr., University of Wisconsin Emory University Yuan Zhai, MD, PhD MD School of Medicine and Neal Iwakoshi, PhD The Dumont-UCLA Medical University of Public Health Emory University Transplant Center South Carolina

ASTS has a 23 year history of supporting basic, clinical and translational research in the field of transplantation and transplant immunology. For 2009, The Foundation of the ASTS-Roche Laboratories ASTS-Roche Laboratories ASTS NKF Folkert Belzer, ASTS Novartis Fellowship ASTS and its awards partners Scientist Scholarship Scientist Scholarship MD Research Award in Transplantation offered over $775,000 in fund- Aaron Ahearn, MD, PhD William Kitchens, MD Thomas Pham, MD Parsia Vagefi, MD ing to ASTS members and their University of California, Emory University The Ohio State University University of California, San Francisco San Francisco trainees.

Visit the ASTS website at www.asts.org/awards to learn more about each award, eligibility, and submission criteria for 2010.

Application submission deadline: January 12, 2010

Roche Presidential Student Roche Presidential Student Roche Presidential Student Roche Presidential Student Mentor Award Mentor Award Mentor Award Mentor Award Award notifications will be James Cassuto, BS Hari Keshava, MS Smaranda Paunescu Julie Sara Wecsler, AB available by: April 2010 New York Medical Case Western Reserve Northwestern University University of Southern College University and Cleve- California land Clinic www.asts.org ASTS Research Awards More Than Just Awards

ASTS has a 23-year history of supporting basic, clinical, and translational research in the field of transplantation and transplant immunology. ASTS and its collaborators developed over a dozen awards to help ensure that highly trained surgeons, physicians, and scientists will be available in adequate numbers and in appropriate research areas to carry out the tasks of transplantation. Below are two stories of how ASTS awards have benefited others. If you are an ASTS award recipient or partner, and would like to share your story, please submit it to [email protected]

ASTS Grant Support: Benefits Beyond Funding Submitted by: Raymond J Lynch, MD, MS, House Officer, University of Michigan Medical Center, 2008 recipient of the ASTS – Roche Laboratories Scientist Scholarship

am a resident in the Department In 2008, I received the ASTS-Roche buttressed my proposal, and assured the I of Surgery at the University of Laboratories Scientist Scholarship to NIH that I had independent support Michigan, commencing my second allow me to investigate accommoda- for the conduct of research. I believe year of research with Dr. Jeffrey Platt. tion in human kidney transplanta- that the investment of the ASTS in my Among various projects, members tion. I am pleased and grateful to have research was the critical factor in the explore accommodation, a condition received this award. Not only because success of my Loan Repayment Program in which cells, tissues or organs acquire it supports my research, but because proposal. resistance to immunological injury. of the credibility that sponsorship by In the setting of ABO-incompatible the American Society of Transplant As I continue in my research and clini- transplantation, accommodation Surgeons provides. Supported by this cal career in transplantation, I hope to is thought to be induced by anti- award, I have secured additional funding maintain close contact with the ASTS. blood group antibodies that bind to from the Loan Repayment Program of Whether as a source of funding, as the transplanted organ. This same the National Institutes of Health. This well as a nexus of financial, practical, phenomenon may occur in reac- program repays educational loans, allow- and intellectual assistance, the ASTS tions against MHC antigens. How ing physicians and surgeons engaged in is an invaluable aid to young surgeons to detect accommodation has been a postdoctoral research to focus on career interested in the field of transplantation. question central to gaining a further development without undue burden. The commitment of the ASTS to assist- understanding of this condition. We The Loan Repayment program is highly ing residents, fellows, and junior faculty postulate that accommodation pro- competitive, and I did not receive a develop a career in research is emblem- tects against both cell-mediated and fundable score on my initial application atic of the overall ethos of transplanta- antibody-mediated injury and that it in the 2007-2008 cycle. When reapply- tion, and encourages young surgeons to may be common response in many, if ing this year, the preliminary findings choose transplantation as a specialty. not most, clinical transplants. generated during support by this award Cycling for A Cause Submitted by: Richard Perez, MD, UC Davis Medical Center, Team Donate Life Board Member

his year Team Donate Life in part- TDL Team Liverators, Tnership with the ASTS awarded an 8-person team that a $50,000 Young Faculty Research included transplant Fellowship to Dr Michael Hughes hepatologists Ray of the Medical College of South Thomason, Terry Box, Carolina. The award is part of ongo- himself a liver recipient, ing efforts to raise funds for research in and Lorenzo Rossaro transplantation by Team Donate Life recently completed the (TDL). TDL is a non-profit organi- Race Across America zation started by Jason and Kristen June 2009 Weckworth, both kidney donors, and www.asts.org Chimera Summer 2009 23 ATC-10-Ad-825x10875-D1 3/19/09 11:39 AM Page 1

ASTS Research Awards More Than Just Awards

a number of health care professionals Jason Weckworth after completing his third RAAM said: at UC Davis Medical Center. All of us “It’s the hardest thing I’ve done in my life… so why do I do it? It’s are recreational cyclists who established TDL as a foundation to utilize cycling quite simple, really. It’s the people… First and foremost, are the as a platform to raise public awareness patients we honor and race on behalf of… we seek media interviews to the benefits of organ donation and across the country so we can share a message of hope for those often to raise funds for transplant research. on the brink of death. Many have died waiting. Some are still with Our main promotional cycling event has been the Race Across America us because of an incredible gift from a selfless donor family or living (RAAM), an annual 3000+ mile donor. I think of my dad, Rodney Weckworth, who is still with us transcontinental race from California 6 years after receiving my kidney, and Staci Smith, who was once to the East Coast. This specific event, a stranger before receiving my wife, Kristen’s kidney last summer. I described as one of the most grueling endurance rides in the world, was cho- consider Terry Box, a TDL teammate and transplant physician who sen to demonstrate the ability of donors himself nearly died from liver failure but survived in the 11th hour and recipients to return to a healthy from the gift of a donor family. I think of the literally hundreds of lifestyle after surgery. family members who have told us of their personal stories of trans- Since 2005, 180 individuals have either plant success, and I cry for those who have shared the loss of their cycled or crewed as part of 11 TDL teams best friends along the way. I believe that what we do matters… a in this non-stop, 24-hour-a-day race over whole lot. I believe that our efforts through RAAM will save some- mountains, across deserts and through one’s life… if not today, then tomorrow, or the next day, or the day the windy, rolling topography of the Midwest. A diverse cast of personalities after that. And I will never stop for that reason. My greatest joy has joined in this adventure. Participants during RAAM is not the finish line… but rather a conversation and have included transplant professionals of picture with a stranger along the way, who smiles and says “I’ve been all types, ranging from surgeons, physi- tracking Team Donate Life, and I love your cause.” cians, nurses, and pharmacists. Friends, families, and fellow church members of patients have joined to support the cause. I appeal to all members of our society ety. There is certainly no shortage of Particularly inspiring have been trans- to consider taking the lead by iden- promising investigators who can benefit plant donors and recipients who have tifying passionate individuals in your from our efforts. Despite the difficult competed in the race. Each individual community who would be interested economic times of the present, I am op- has their own story about the months in establishing a local TDL chapter in timistic that many will answer this call of training, the immense organizational your city. Since racing in RAAM may for our profession and our patients. challenges of crew coordination, and the not be for everyone, we have broadened To find out more about the Team thrill of meeting other cyclists from all our platform so individuals can raise Donate Life contact Richard Perez at over the world. Overall, the experience funds by participating in local running [email protected] or visit of trekking across the continent on two or cycling events. The overall goal is to http://www.teamdonatelife.com. wheels to support a cause we believe in increase funds to support more research has been life changing. awards sponsored through our soci- ASTS Announces WTC 2014 24 Chimera Summer 2009 www.asts.org ATC-10-Ad-825x10875-D1 3/19/09 11:39 AM Page 1 Job Board

ASTS provides this Job Board as a benefit to our members. This is an abbreviated listing of the positions currently available on the ASTS website. Please log into the members’ portal to view the positions in their entirety at www.asts.org. If you would like to submit a listing, please contact Chantay Parks Moye at [email protected] or 703 414-7870 ext. 101for submission guidelines and fee requirements.

Me d i c a l Di r e c t o r (Pa r t Ti m e ), Or g a n Tr a n s p l a n t Pr o g r a m Di r e c t o r : Ki d n e y Tr a n s p l a n t /Ge n e r a l Su r g e o n : Gi f t o f Li f e Do n o r Pr o g r a m Sw e d i s h Me d i c a l Ce n t e r i n Se a t t l e La n k e n a u Ho s p i t a l Please contact: Please contact: Please Contact: Mike Waters James Lim, MD, FACS Program Director Gift of Life Donor Program Physician Recruiter Lankenau Hospital Human Resources Phone: 206 320.5962 4404 Medical Sciences Bldg 401 North 3rd Street Email: [email protected] 100 Lancaster Ave Philadelphia, PA, 19123 Wynnewood, Pa 19096 Fax: 215 963.0702 Email: [email protected] Ya l e Un i v e r s i t y Sc h o o l o f Me d i c i n e : Phone: 610 645.6403 Email: [email protected] Tr a n s p l a n t Su r g e o n T32 Po s t -Do c t o r a l Re s e a r c h Please contact: Fe l l o w s h i p s i n Tr a n s p l a n t a t i o n As s o c i at e Di r e c t o r : Sukru Emre, MD Im m u n o l o g y a n d St e m Ce l l Bi o l o g y - Th e Ha r t f o r d Ho s p i t a l Professor of Surgery and Pediatrics Un i v e r s i t y o f Lo u i s v i l l e Chief, Section of Transplantation and Ki d n e y Tr a n s p l a n t Pr o g r a m Please contact: Please contact: Immunology Frances Chapman Director, Yale-New Haven David Hull, MD Transplant Program Administrative Officer, ICT Transplantation Center Institute for Cellular Therapeutics Department of Surgery Hartford Hospital 85 Seymour Street University of Louisville, School of Medicine Yale University School of Medicine 570 South Preston Street, Ste 404 333 Cedar Street, FMB 112, PO Box MOB Suite 321 Hartford, CT 06106 Louisville, KY 40202 208062 Email: [email protected] New Haven, CT 06520-8019 Email: [email protected]

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Contact ASTS for testimonials or to schedule your MMS today!

703.414.7870 www.asts.org [email protected] Corporate Support The American Society of Transplant Surgeons would like to thank the following companies for their generous support in 2009. ASTS held a reception in their honor during the 2009 American Transplant Congress in Boston. Dr. John P. Roberts, Immediate Past President, presented the awards.

Benefactor Circle Founder Circle President Circle

Charlotte Berlin, Timothy Waugh, Tina Deignan, Product Director VP Transplant Senior Director

President Circle President Circle Sponsor Circle

John Weinberg, Sheila Talafous, Chris Soria, Director of Marketing Senior Director, Senior Product Manager Professional Affairs

Associate Circle Supporters

www.asts.org Chimera Summer 2009 27 The Foundation of the

National Office Dear ASTS Members, 2461 South Clark Street Suite 640 We’re not just Proud, We’re ASTS PROUD! Arlington, VA 22202 Phone: 703 414-7870 The American Society of Transplant Surgeons (ASTS) is proud to offer educational initiatives to influence Fax: 703 414-7874 transplantation, along with cultivating and advancing your career. As ASTS continues to grow, we are asking www.asts.org/ASTSFoundation every member to become more involved because you are the key to combating the issues that threaten the prog- ress of transplantation. President John P. Roberts, MD This year began with triumphs for transplantation while recent headwinds have stifled a plethora of healthcare Univ. of California San Francisco resources. ASTS helped secure $10 million in funding for organ donation and transplantation (with antici- pated inclusion in the next Senate budget bill), and we maintain a robust annual awards program offering over Vice President $775,000 a year to recipients, while transplant research received $200 million when the 2009 Recovery Act Robert M. Merion, MD awarded funds to the National Institutes of Health for challenge grants. We ask that you remain confident that University of Michigan ASTS will remain dedicated to providing you with the best resources, programs, and training.

Secretary/Treasurer ASTS is one of the most sought after primary resources for the evolution and advancement of transplantation. In Alan N. Langnas, DO fact, NATCO, the Organization for Transplant Professionals, has partnered with ASTS to establish dual member- University of Nebraska ship. This collaboration will provide both organizations with the opportunity to expand our efforts in the transplant community. Dozens of nurse practitioners and physician assistants have also joined the ranks. In recent years, the Immediate Past President ASTS membership has amplified by over 20%, a testimonial that ASTS is doing something right! Goran B. Klintmalm, MD, PhD Baylor Regional Transplant Inst. You can expect continued commitment from the ASTS on: . Funding transplantation research Board of Directors . Training and education Michael M. Abecassis, MD, MBA . Topic-driven symposia and consensus conferences Kim M. Olthoff, MD . Development of business practice services and education, career development and strong advocacy on Richard B. Freeman, Jr., MD legislative and regulatory issues Dixon B. Kaufman, MD, PhD . The American Transplant Congress (ATC) Timothy L. Pruett, MD . The # 1 journal in transplantation, American Journal of Transplantation (AJT) James D. Eason, MD . Advancing the science and practice of transplantation Charles M. Miller, MD Peter G. Stock, MD, PhD We know that you care about receiving high quality information regarding training, legislation, regulatory, and R. Mark Ghobrial, MD, PhD reimbursement issues that affect you, so now is the time to act. Robert S. Higgins, MD, MSHA Elizabeth A. Pomfret, MD, PhD Contribute to the Foundation of the ASTS today. To make a gift by phone, please call 703.414.7870 ext. 100 or online at http://www.asts.org/astsfoundation. Executive Director Katrina Crist, MBA If you are new to ASTS, you may have questions about the Society. Spend some time talking with trained staff at the ASTS National Office at 703.414.7870 [email protected] g.

We value your continued trust in us, and thank you for your gift.

Sincerely,

John P. Roberts President, Foundation of the ASTS

Proud of Who We Are, Proud of What We Do Calendar The ASTS is pleased to coordinate with other professional organizations in order to maintain a relevant events calendar. If your organization would like to list an event, please contact Chantay Parks Moye at 703.414.7870 ext. 101 or [email protected] .

September 2009 p c o m i n g January 2010 September 3-5, 2009 U ASTS January 15 -17, 2010 American Association of Kidney Patients Ev e n t s ASTS State of the Art Winter Symposium (AAKP) The Cutting Edge of Transplant Surgery 36th Annual National Convention Pre-Meeting: Clinical Research Hyatt Regency Denver in Transplantation Denver, Colorado Harbor Beach Marriott, Jerome A. Bailey, Ft. Lauderdale, FL January 15 -17, 2010 Communications Manager Phone: 800-749-AAKP ASTS State of the Art Winter January 12-17, 2010 Email: [email protected] Symposium Symposium for the Advanced Transplant www.aakp.org/events/convention/2009 The Cutting Edge Professional of Transplant Surgery NATCO September 11-12, 2009 Harbor Beach Marriott, FL 9th Meeting of the International Pre-Meeting: Clinical Research www.natco1.org Society of Hand and Composite Tissue Allotransplantation in Transplantation Release Date: May 22, 2009 Valencia, Spain Expiration Date: May 22, 2010 www.ctavalencia2009.com Harbor Beach Marriott, Managing Symptoms and Monitoring E-mail: [email protected] Ft. Lauderdale, FL Progress in the Graft Recipient: Abstract and Video Submission The Patient Perspective September 13-14, 2009 Deadline: September 9, 2009 Presented by Drs. Stuart Flechner and Extracorporal Support Matthew Weir in Organ Donation and Transplantation www.asts.org www.freecme.com/gcourse_view. The Extracorporeal Life Support php?course_id=8133 Organization October 30-November 3, 2009 Ann Arbor, MI The Liver Meeting 2009 February 2010 www.elso.med.umich.edu/meetings.htm AASLD February 4-7, 2010 Boston 9th International Conference on New September 23-26, 2009 www.aasld.org/thelivermeeting/Pages/ Trends in Immunosuppression Transplant Immunosuppression: default.aspx and Immunotherapy Today’s Issues Kenes International Radisson University Hotel October 30-31, 2009 Prague Minneapolis, MN Keeping the Patient With End-stage www.kenes.com www.cmecourses.umn.edu Cirrhosis Alive 2009 Postgraduate Course February 7-8, 2009 October 2009 Boston Intestinal Failure: Latest Advances in October 8-9, 2009 www.aasld.org/thelivermeeting/Pages/ Diagnosis and Treatment Living Kidney Donation Conference & default.aspx Including Transplantation Donor Advocacy Training American Society for Parental American Foundation for Donation & November 2009 and Enteral Nutrition Transplantation (formerly SEOPF) November 3-6, 2009 Las Vegas The Hutton Hotel National Conference to End Health www.nutritioncare.org Nashville, TN Disparities IIF Contact: Arlene Skinner Faces of A Healthy Future April 2010 Phone: 804-323-9890 Center of Excellence, April 13–17, 2010 www.amfdt.org Winston-Salem State University NKF 2010 Spring Clinical Meetings Twin City Quarter, Winston-Salem, NC Walt Disney World Swan and Dolphin Phone: 336-779-7361 Orlando, Florida www.facesofahealthyfuture.com www.nkfclinicalmeetings.org www.asts.org Chimera Summer 2009 29 New Members For more information on becoming a member, visit www.asts.org or contact the ASTS National Office at (703) 414.7870 or [email protected]

Joachim Andrassy, MD Christine A. Tabor, MSN, CRNP, CCRN Sandra Cantera, RN, BSN University Hospital Grosshardern, Ludwig University of Maryland Medical Center The Lankenau Hospital Janet M. Bellingham, MD Douglas K. Tadaki, PhD Philip Carlson, RN, RNP, CPTC University of Wisconsin School of Medicine Naval Center Arkansas Regional Organ Recovery Agency David A. Bruno, BA, MD Karoly Varga, MD Lana Casica, RN, BSN Emory University University of Texas Health Science Center Houston OSF St. Francis Medical Center Leonard M. Canessa, MD Philip Y. Wai, MD Lori Coleman, RN, CPTC The Children’s Medical Center of Dayton University of Wisconsin-Madison California Pacific Medical Center Keith M. Cavaness, DO Jeffrey Warren, MD, FRCSC Stephanie Collazo, RN, CCRN, CNS, CPTC Baylor University Medical Center London Health Sciences Centre OneLegacy Brandi L. Cominos-Liggins, MSN, FNP-BC Baris D. Yildiz, MD Carrie Comellas, RN, CPTC Methodist University Hospital Baylor Regional Transplant Inst Stony Brook University Amanda G. Dean, MSN, RN, ACNP-BC Yuan Zhai, PhD Suzanne Conrad, RN, MS Methodist University Hospital UCLA Transplant Center - The Dumont Donor Network Oleg Dolghi, MD Danielle Cornell, RN, BSN University of Iowa Hospitals & Clinics ASTS We l c o m e s Du a l LifeQuest Organ Recovery Services Susan T. Ferrara, BSN, MSN ASTS/NATCO Me m b e r s S. Wade Crowson, RN, BSN, CCTC University of California Davis Medical Center Marlene Abe, RN, BS, CPTC University Medical Center St. Joseph Hospital Cass Franklin, MD, FACS Theresa Davis, RN, CPTC Mercy Transplant Medical Center - Des Moines Stacey Abel, RN, BSN, CCTC LifeLine of Ohio Iowa City VA Med. Center Ganesh Gunasekaran, MD Ginger Delario, PhD, MT,ASCP, CPTC Cleveland Clinic Foundation Deborah Andersen, RN, BSN Carolina Donor Services University of Nebraska Medical Center Frank D. Irwin, MD Nancy Duncan, RN, BSN OptumHealth Care Solutions Joan Arata, RN, BSN The Clarian Transplant Center Intermountain Transplant Center Colleen L. Jay, MD Susan Dunn, RN, BSN, MBA, CPTC Northwestern University - Feinberg School Sarah Armstrong, BA Donor Alliance of Medicine Canterbury District Health Board Gina Dunne Smith, BS Cheol Woong Jung, MD Carolyn Atkins, RN, BS, CCTC International Institute for the Advancement of University of Cincinnati Hospital Children’s Medical Center Medicine Nitin N. Katariya, MD Wayne Babcock, RN, BSN Rosemary Durning, PA, BA Northwestern University - Feinberg School Babcock Consulting, LLC New England Organ Bank of Medicine Kristine Baker, RN, BSN Donna Ennis, RN, CCTC Kamran Khanmoradi, MD Cedars-Sinai Medical Center The Clarian Transplant Center Albert Einstein Medical Center Denise Batchelder, RN, BSN, CPTC Tracy Evans-Walker, RN, BSN, CCTC Ingo Klein, MD New England Organ Bank Cleveland Clinic Foundation University of California - San Francisco John Belcher, CCEMT-P, CTBS, CPTC William Faircloth, RN, CEBT, AA Daniela P. Ladner, MD New England Organ Bank LifeShare of the Carolinas Northwestern Memorial Hospital Renee Bennett, RN, BSN, CNOR, CCTN Jan Finn, RN, MSN, CPTC John W. McGillicuddy, MD Cleveland Clinic Foundation Midwest Transplant Network Medical University of South Carolina Sandra Berney, RN, ASN, CCTC Vicki Fioravanti, RN Ivaylo I. Mitsiev, MD St. Vincent Hospital Children’s Mercy Hospital New York University Roberta Billman, RN, MSN, CNN Susan Fleagle, RN, BSN, CCTC, CCM Ido Nachmany, MD The Rogosin Institute University of Maryland University of - Starzl Transplant Institute Jamie Blazek, MPH, FNP-C Phyllis Freeman, RN, BSN Henrik Petrowsky, MD Ochsner Multi-Organ Transplant Center Mercy Hospital Medical Center UCLA Transplant Center - The Dumont Karen Bramley, RN, CNN, CCTC Tommy Frieson, BS, CPTC Christina B. Pippin, RN, CPTC Porter Transplant Service Clinical Consulting Associates Alabama Organ Center Katrina Bramstedt, PhD, FRSM Liana Frost, RN Anthony T. Rezcallah, MD California Pacific Medical Center Mercy Hospital Medical Center University of Minnesota S. Diane Brockmeier, RN, BSN, MA Mimi Funovits, RN, BS Luke Y. Shen, MD Mid-America Transplant Services Starzl Transplantation Institute Emory University Scott Brubaker, CTBS Catherine Garvey, RN, BA, CCTC James J. Stone, MD American Association of Tissue Banks University of Minnesota Medical Center University of Minnesota It’s Truly A Great Time To Be A Member

30 Chimera Summer 2009 www.asts.org Patrick Geraghty, EMT-P, BS, CPTC Tammy Lovewell, RN, BSN, CCTC Nancy Satmary, RN, BSN, MHCA, CCTC Donor Network of Arizona University Massachusetts Medical Center St. John Hospital & Medical Center Kevin Gramlich, RN, CPTC Brigette Marciniak-Bednar, RN, BSN James Schneider, EMT, CHT, CPTC Upstate New York Transplant Services Jackson Memorial Hospital Finger Lakes Donor Recovery Network Paula Gull, RN, MSN, ANP, CS, CNN Lori Markham, RN, MSN, CCRN, CPTC Teresa Shafer, RN, MSN St. Joseph Hospital Midwest Transplant Network LifeGift Organ Donation Center Judith Hambleton, RN, SRN Daren Marshall, BASW, MEd, LSW Heather Shank-Givens, CPTC Rogosin Institute LifeBanc Washington Regional Transplant Community Ruthanne Hanto, RN, MPH James McCabe, MS Gigi Sommerauer, RN, BSN New England Organ Bank New England Organ Bank Midwest Transplant Network Sheila Harms, RN, MSN, CPTC Gwen McNatt, RN, CNN, CFNP Jill Speicher, RN, BSN, CCTC New England Organ Bank Northwestern Memorial Hospital Massachusetts Memorial Hospital Ruth Havens, RN, BSN Linda Miller, RN, CHPN, MPH Elizabeth Stanzione, RN, CPTC SUNY Health Science Center University of Toledo LifeNet Health Renee Hawthorne, BS Deborah Mountain, RN, AA Dorothy Starr, RN, BSN OneLegacy University of California Irvine Medical Center Texas Organ Sharing Alliance Douglas Heiney, BBA Anne Murphy, MBA Tracy Steinberg, RN, MSN, CNS United Network for Organ Sharing University of Michigan University Hospital-Transplant Surgery Randall Heyn-Lamb, RN, BSN Craig Myrick, RN, CPTC Daniel Stockdreher, MPH University of Southern California Intermountain Donor Services Clinical Consulting Associates Deborah Himmel, RN, BSN Howard Nathan, BS Debra Strichartz, RN, BA OSF St. Francis Medical Center Gift of Life Donor Program Stanford Pediatric Liver Transplant Program Ursula Hobbs, RN, BSN Joyce Nekoba, MSN, RN, CNN, CCTC Rodney Strothcamp, CPTC Thomas Jefferson University Hospital University of California San Francisco Mid-America Transplant Services Judith Hoff, RN Susan Noska, RN, CNN, CCTC M. Kevin Stump, RN, BSN St. Louis University Hospital Massachusetts General Hospital Mississippi Organ Recovery Agency Veda Hope, RN, BS, CNN, CCTC Jean Novak, RN, BSN, CCTC, CPTC Sharon Swofford, RN, CNN, MA Erlanger Thomas Jefferson University Hospital United Healthcare Bette Hopkins-Senecal, RN, BSN, MS Lori Noyes, RN, BSN, CCTC Roxanne Taylor, RN, MSN Rhode Island Hospital Riverside Community Hospital Maine Medical Center Monica Horn, RN, CCRN, CCTC Barbara Nuesse, RN, BSN, CCTC, CPTC Janel Tedesco, RN, BSN, ACNP Children’s Hospital of Los Angeles Orange Park Florida UT Southwestern Medical Center Laura Huckestein, RN, BSN Robin Ohkagawa, RN, BSN Dave Teune, CPTC New England Organ Bank New England Organ Bank New England Organ Bank Kelley Jaeger Jackson, RN, BSN Carolyn Olivarez, LPN/LVN Joyce Tobin, RN, AA Sutter Medical Center LifeGift Organ Donation Center Dumont-UCLA Transplant Center Jennifer Jeter, ADN-RN Karen O’Neill, RN, CNN Jacqueline Trammell, RN, NP, MSN Memorial Hermann Hospital Thomas Jefferson University Hospital Kaiser Santa Clara (TPMG) Linda Jones, RN Marian O’Rourke, RN, CCTC Maxine Uniewski, RN LifeLine of Ohio Tulane University Hospital & Clinic Henry Ford Hospital LeAnne Jones, RN, BSN, CCTC Kim Patton, RN Sean Van Slyck, BA Shands Hospital University of Florida California Transplant Donor Network California Transplant Donor Network Peggy Kearney-Hoffman, RN, BSN Patricia Pavlak, RN, BSN, CCTC, CPTC Carol Vincel, RN, MSN, ACNP Sutter Medical Center Rogosin Institute University of Virginia Health System Anne Marie King, RN, BA, BSN, MA, CCTC Amy Peele, RN Doyce Williams, MA Massachusetts General Hospital University of California San Francisco Alabama Annette Klemme, RN, BSN, MBA Deborah Pierce, RN, CCTC Bernadette Winiker, RN University of California San Francisco Froedtert Hospital and Med. College of WI North Austin Medical Center Amy Knight, RN, BS, CCTC Jennifer Prinz, RN, BSN, MPH, CPTC Lisa Yoder, RN, BSN Scripps Green Organ & Cell Transplant Donor Alliance The Methodist Hospital System Rob Kochik, RN, BSN Merit Qviste, RN, CNN Mindy Zoll, RN, CPTC Finger Lakes Donor Recovery Network University Transplant Program TransLife Florida Hospital Gloria Lardieri, RN, BSN, CCTC Elizabeth Roach, RN, BSN Transplant Surgery Intermountain Donor Services Sandra Leyden, RN, MA Lori Rosenthal, DrNP, NP-C, ACNP-C UCSD Transplant Center New York-Presbyterian Medical Center James Locke, CTOP II Carolyn Ruge, RN OneLegacy Life Connection of Ohio Karen Lord, RN, CCRN, MS, FNP Karen Samartan, RN, BSN, CNOR, CPTC New England Organ Bank OneLegacy It’s Truly A Great Time To Be A Member www.asts.org Chimera Summer 2009 31 35th Anniversary

ASTS Na t i o n a l Of f i c e 2461 So u t h Cl a r k St r e e t Su i t e 640 Ar l i n g t o n , VA 22202

ASTS 10th Annual State of the Art Winter Symposium

The Cutting Edge Of Transplant Surgery

Pre-Meeting Course January 14 – 15, 2010

Winter Symposium January 15 – 17, 2010

Marriott Harbor Beach, Ft. Lauderdale, FL