Published for Members of the American Society of Transplant Surgeons
Vol. XV, No. 2 Winter 2010
President’s Letter 4 Member News 6 Regulatory & Reimbursement 8 Legislative Report 11 NLDAC 15 State of the Art Winter Symposium 16 3rd Annual Surgical Fellows Symposium 20 Fellows Match Program 22 American Transplant Congress 2010 23 ASTS Research Awards 24 ASTS Job Board 26 Corporate Support 27 Foundation 28 Calendar 29 New Members 31
www.asts.org ASTS Council May 2009–May 2010
President Treasurer 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 Email: [email protected] Email: [email protected] Peter G. Stock, MD, PhD (2011) University of California San Francisco President-Elect Councilors-at-Large Dept. of Surgery, Rm M-884 Michael M. Abecassis, MD, MBA (2010) Richard B. Freeman, Jr., MD (2010) 505 Parnassus Avenue Northwestern University 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 Chicago, IL 60611 750 Washington Street, Box 40 Email: [email protected] Phone: 312 695.0359 Boston, MA 02111 Fax: 312 695.9194 Phone: 617 636.5592 R. Mark Ghobrial, MD, PhD (2012) Email: [email protected] Fax: 617 636.8228 The Methodist Hospital Email: [email protected] Dept. of Surgery Immediate Past President 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 Medical 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 San Francisco, CA 94143-0780 Galter Pavilion Suite 17-200 Robert S. Higgins, MD, MSHA (2012) Phone: 415 353.1888 Chicago, IL 60611 Rush Presbyterian St. Luke’s Fax: 415 353.8709 Phone: 312 695.0257 Medical Center Email: [email protected] Fax: 312 695.9194 Dept. of Cardiovascular & Thoracic Surgery Email: [email protected] 1725 W. Harrison Street, Suite 1156 Past President Chicago, IL 60612 Goran B. Klintmalm, MD, PhD (2010) Timothy L. Pruett, MD (2010) Phone: 312 942.6373 Baylor Regional Transplant Institute University of Minnesota Fax: 312 563.4700 3500 Gaston Avenue Department of Surgery Email: [email protected] Dallas, TX 75246 420 Delaware Street SE Phone: 214 820.2050 MMC 195 Elizabeth Pomfret, MD, PhD, FACS (2012) Fax: 214 820.4527 Minneapolis, MN 55455 Lahey Clinic Medical Center Email: [email protected] Phone: 612 626.7282 Dept. of Transplantation Fax: 612 624.7168 41 Mall Road, 4 West Secretary Email: [email protected] Burlington, MA 01805 Kim M. Olthoff, MD (2011) Phone: 781 744.2500 University of Pennsylvania Hospital James D. Eason, MD (2011) Fax: 781 744.5743 Department of Surgery Methodist University Hospital Email: [email protected] 3400 Spruce Street, 2 Dulles University of Tennessee Philadelphia, PA 19104 Department of Surgery National Office Phone: 215 662.6136 Transplant Inst., 1265 Union Avenue, 10 Katrina Crist, MBA Fax: 215 662.2244 Service, S1011 Executive Director Email: [email protected] Memphis, TN 38104-3499 2461 South Clark Street, Suite 640 Phone: 901 516.7070 Arlington, VA 22202 Fax: 901 516.2036 Phone: 703 414.7870 Email: [email protected] Fax: 703 414.7874 Email: [email protected]
2 Chimera Winter 2010 www.asts.org Editor’s Letter 5th Anniversary
Published for Members of the American Society of Transplant Surgeons Published for Members of the American Society of Transplant Surgeons Published for Members of the American Society of Transplant Surgeons
35th Anniversary Vol. XIV, No. 3 Spring 2009 Vol. XV, No. 1 Summer 2009 Vol. XV, No. 2 Winter 2010
Presidents Letter 4 President’s Letter 4 President’s Letter 4 Member News 6 Member News 6 Member News 6 Regulatory & Regulatory & Legislative Report 8 Reimbursement 8 Reimbursement 8 Regulatory & Legislative Report 10 Legislative Report 11 Reimbursement 10 OPTN/UNOS Corner 12 NLDAC 15 OPTN/UNOS Corner 12 35th Anniversary State of the Art LYFT 13 of ASTS 14 Winter Symposium 16 NLDAC 15 Historian Report 18 3rd Annual Surgical State of the Art American Transplant Fellows Symposium 20 Winter Symposium 16 Congress 2009 Fellows Match American Transplant Winter Symposium 19 Program 22 Congress 2009 22 Beyond the Award 23 American Transplant Video Library 25 Corporate Support 27 Congress 2010 23 Job Board 27 Foundation 28 ASTS Research Corporate Support 28 Awards 24 Calendar 29 Foundation 29 ASTS Job Board 26 New Members 31 Calendar 30 Corporate Support 27 New Members 31 Foundation 28 Calendar 29 New Members 31
www.asts.org www.asts.org www.asts.org
elcome back to another edi- Roche and Bristol-Myers Squibb, and Of course, in addition to all that’s been tion of the Chimera! The it continues to be a rousing success. mentioned above, this edition of the Wdays are growing short as we This symposium is always a highlight Chimera is filled with all sorts of other head into another winter. One bright for our fellows. Besides the significant useful and interesting news, in all of spot of this cold and snowy season (at educational value, it provides fel- the usual columns and regular features. least for those of us above the Mason lows with a first chance to connect Read it and enjoy! Dixon line) is always the ASTS State of with their peers and to form lifelong the Art Winter Symposium. This year friendships and professional associa- See you in Fort Lauderdale! we’ll be moving over to the east coast of tions. I still remember my symposium Florida, in Fort Lauderdale, as we con- from 15 years ago. Check out the Best Regards, sider “The Cutting Edge of Transplant story and photos on page 20. James Whiting, MD Surgery.” As always, the meeting will Chair, Communications Committee provide an intimate, more relaxed and As always, the Chimera is chock full family friendly atmosphere, something of news on the legislative and regula- Chantay Parks Moye a little different from the American tory front. Please read this important Managing Editor Transplant Congress. This year’s pro- information closely starting on page [email protected] gram promises to be interesting and fun! 8. To be an effective advocacy group For a full description, turn to page 16 in for you and our patients, we need an Karol A. Keane this edition. informed and involved membership. Design & Communications, Inc. We want to hear your opinions. In www.keanedesign.org While we’re considering warm winter addition to following legislative news retreats, this year’s ASTS Annual Fel- in the Chimera, signing up for the lows Symposium took place in Novem- ASTS RSS feeds from the website ber in Scottsdale, Arizona. This was is another great way of staying in- the third year of ASTS sponsorship of formed. this program with funding from Astellas,
About the Cover
The cover photograph was taken at the Medical University of South Carolina (MUSC). The image is instrumentation for lapa- roscopic donor nephrectomy / liver resection. ASTS member, Kenneth Chavin, MD, PhD was the performing surgeon. The pa- tient had congenital cysts on the liver. ASTS is grateful to Dr. Chavin for the invitation to join the transplant team at MUSC in the operating room. ASTS strives to provide members with real surgical photographs that depict what you do.
If you have a photograph that would like displayed on the cover of the Chimera, please email it along with a brief description to Chantay Parks Moye at [email protected].
www.asts.org Chimera Winter 2010 3 President’s Letter
Greetings from your ASTS President! and to encourage surgically oriented, thematically structured topics. After you’ve been doing anything for a decade, it’s a good time to pause for The ASTS State-of-the-Art Winter reflection. Ten years is a nice round Symposium has succeeded beyond our number, and for some reason it con- expectations! While attendance has veys the impression of being weightier increased every year, it still has that than nine or eleven. This year, the special feel to it. It’s a unique opportu- American Society of Transplant nity to catch up with colleagues from Surgeons celebrates a decade of not around the country and advance your one, but three important initiatives: knowledge in a discrete area (this year’s The American Journal of Transplantation theme is The Cutting Edge of Transplant (AJT), the ASTS State-of-the-Art Surgery), with new and exciting advanc- Winter Symposium, and the American es presented in a relaxed environment. Transplant Congress (ATC). Each is In addition to its appeal to transplant focused on our educational and re- surgeons, the program includes offerings search mission to advance the field of attractive to other clinicians, research- transplantation, and each has enjoyed ers, allied health professionals, advanced remarkable success. Robert M. Merion, MD transplant providers, and trainees. ASTS President And, as the meeting has expanded, When the AJT was conceived in the we’ve added special seminars, forums, late 1990s as a joint venture of the 2010. This scientific meeting drew its debates, and audience feedback. We ASTS and the American Society of inspiration from the early ASTS meet- recently accepted a generous invita- Transplantation (AST), there were ings at the Drake Hotel in Chicago in tion from the American Foundation many who thought we already had more the 1970s, at a time when there were for Donation and Transplantation to than enough peer-reviewed journals many fewer ASTS members, and the institute and fund a new named lecture in the field. Ten years later, under the clinician-scientists and basic science at the Winter Symposium to honor the extraordinary leadership, high standards, researchers in our young field were able memory of Dr. David Hume, a pioneer and seemingly inexhaustible en- to present all the oral abstracts without transplant surgeon from the Medical ergy of inaugural editor-in-chief Philip resorting to concurrent sessions! There College of Virginia. We are excited Halloran, AJT justifiably boasts the was plenty of time allotted for discussion that Dr. Nicholas Tilney will be the highest impact factor among all jour- of each abstract, and heated debates inaugural Hume Lecturer and hope that nals in transplantation, and the second often ensued between discussants and you will join us for this exciting part of highest among all surgical journals. The presenters. Another important ele- the program. See all the details about mean turnaround time of 22 days from ment that contributed to the meeting’s the Winter Symposium on the ASTS submission to initial decision is the envy success was the opportunity for members website (http://www.asts.org/Tools/News. of most competitor journals, and is like to meet informally with their peers as aspx?content_id=793). the difference between warp speed and well as with the pioneers in our field. walking in comparison to many. After Nowadays we call it networking. There To round out the celebration of our ten years at the helm, Dr. Halloran will was a relaxed and convivial feel to the three decade-long projects, we will hold be stepping down as editor-in-chief in meeting. With the advent of the ATC the 10th American Transplant Congress 2010, and the ASTS, along with AST, meeting, another joint project of the meeting in San Diego in the spring of has begun the process of identifying and ASTS and AST, concurrent sessions 2010. This 5-day meeting (May 1-5, selecting his successor. We have great were introduced and the meeting has 2010) has become renowned as a venue confidence thatAJT will continue to been hugely successful, but as it’s gotten for the presentation of world class reach for and achieve the highest level bigger it has lost the intimacy of the research on every possible transplant- of excellence as the flagship journal in early ASTS gatherings. The ASTS related subject. Outstanding keynote our field. Council empowered the Vanguard speakers are lined up, a wide variety of Committee (which represents more ju- presentation formats are planned, and The 10th Annual ASTS State-of-the- nior members of ASTS) to put together I promise to do my best to avoid boring Art Winter Symposium will be held a high quality scientific meeting in the you with my presidential address. Look in Ft. Lauderdale on January 15-17, winter as a counterpoint to the ATC for more detailed information about the
4 Chimera Winter 2010 www.asts.org program, which will include a special living organ donors of kidneys, livers, procedure requirements. Many individu- 10th anniversary scientific session and and occasionally other organs each year. als have been working on this initiative. celebration on Saturday, May 1, 2010 Advocating for living donors has been a Douglas Hanto has been our liaison to and much, much more. longstanding initiative of the ASTS. the American Board of Surgery and the Residency Review Committee. Jonathan While we’ve been very successful in I would also like to remind you that Fryer and John Magee have been spear- many areas, we have some initiatives ASTS continues to advocate on your heading the generation and dissemina- that require our continued efforts and behalf for retention of general surgery tion of rotation educational objectives. attention. Health care reform legisla- residents on transplant services, as there Elizabeth Pomfret has identified modules tion is being hotly debated as I write is broad agreement from our members of the ASTS Academic Universe online this, and it is likely that there will that these rotations offer great educa- curriculum that are appropriate for ultimately be a bill passed that President tional opportunity. A couple of years resident education. But, we all need to Obama will sign into law. Whether it’s ago, it looked like we were going to lose do our part within our individual training the so-called public option, enhance- transplant rotations as a part of gen- programs to ensure that the rotations are ments to Medicare, or fixes to physician eral surgery residency training. It was meaningful and educationally worthwhile reimbursement, virtually everyone has proposed that transplant surgery become for the residents. Please engage your local an opinion and a stake in the outcome. an optional elective rotation, which Residency Program Directors in this pro- But amidst the broad sweeping propos- would almost certainly have meant the cess. A follow-up survey of residents and als, the ASTS continues to advocate demise of this opportunity. Operative general surgery program directors is likely tirelessly for kidney transplant recipi- experiences were generally poor and the to occur in 2010, so we should continue ents, who are still faced with the loss of level of non-educational work (aka scut to be attentive to this issue. There will Medicare coverage for immunosuppres- work) was high, as described by residents be a special session at the ASTS Winter sion drugs after three years unless they and general surgery program directors in Symposium on this topic on Friday, are over age 65 or retain Medicare eligi- a survey by the Association of Program January 15, 2010. Don’t miss it! bility on the basis of permanent medical Directors in Surgery. We’ve worked disability. ASTS has worked tirelessly very hard to make the case that these As you can tell, we are working hard but unsuccessfully to correct this obvi- rotations can be an extremely valuable to fulfill the broad ASTS mission: ous defect in the Medicare law for more component of general surgery training Fostering and advancing the practice than a dozen years, and we hope that and to strongly encourage transplant and science of transplantation for the we will be successful this time, most programs to re-examine and improve the benefit of patients and society. likely in the form of an amendment to resident experience. After all, given the the health care reform legislation. If progressive movement toward mini- With warmest regards, we contact you to appeal to your state’s mally invasive procedures, transplant congressional delegation, I sincerely surgery offers a wealth of open operative hope you will respond. cases, as well as a wide range of other surgical experiences and opportunities Equally important to the transplant com- for exposure to management of organ munity is the element of most health care failure and opportunistic infection. One Bob Merion reform legislation proposals that would measure of the positive impact of our eliminate pre-existing conditions. This efforts has been the decision to allow is critically important for those thou- residents to count kidney transplant cases sands of selfless individuals who become towards their mandatory open vascular ASTS Announces WTC 2014 www.asts.org Chimera Winter 2010 5 ASTS News The ASTS Fall Council and Committee Chair Meeting was held September 14-15, 2009 in New York, NY. The following are select committee news and reports from the meeting.
ABS Report committee provided feedback on the on the structure of transplant centers and Dr. Douglas Hanto reported that the informed consent resource document. institutes that would describe the admin- new members of the Transplant Advi- istrative structures currently in use with sory Council (TAC) are Drs. Andrew Advanced Transplant Providers comprehensive analysis. The council de- Klein and Charles Miller. He reported (ATP) Committee cided against the white paper initiative. that ABS decided not to change the Ms. Deborah Hoch reported that the recertification exam to a modular type. council moved the ad hoc committee Cell Transplant Committee The TAC is urging ASTS to develop a established for nurse practitioners and Dr. Steve Paraskevas reported that monthly reading program as part of Part physician assistants to a standing com- ASTS met with Dr. Barry Straube, Chief 2 of the Maintenance of Certification mittee. The council approved a survey Medical Officer and Director of the Di- (MOC) that focuses on Lifelong Learn- to assess the needs of the advanced prac- vision of Clinical Standards and Quality, ing and Self-Assessment. There was tice group. and his colleagues in June to follow up also discussion on efforts to add trans- on a proposed change to reimbursement plant cases to ACGME case logs and AJT Update for pancreata used for islet cells. He re- the development of methodologies to Dr. Robert Merion updated the council on ported that the committee is developing satisfy individual requirements for Part 4 the editor-in-chief search to succeed Dr. a session on islet transplantation at the of MOC. Philip Halloran in September 2010. Dr. winter symposium in January and pre- Sandy Feng reported that the American sented a preliminary program. Ad Hoc Committee Journal of Transplantation is planning on Vascularized Composite a 10th anniversary celebration in 2010 Communications Committee Allograft (VCA) that will be held in conjunction with the Dr. James Whiting presented a proposal Dr. Linda Cendales reported that the American Transplant Congress (ATC). to implement a “Your Opinion Matters” committee changed its name from Com- section on the ASTS website to pro- posite Tissue Allograft to VCA to be Business Practice Committee mote more member feedback on policy more associated with solid organ trans- Dr. David Axelrod reported that the proposals, legislative and regulatory is- plantation than with tissue transplanta- survey instrument for the 2010 com- sues and other activities. The council tion. The field is interested in HRSA pensation survey is complete and that approved development of this section. making a determination that VCA will the survey will be sent out this fall. He Dr. Whiting reported that the commit- be recognized as a solid organ and the updated the council on the business prac- tee would like to introduce social net- committee is drafting guidelines for pro- tice seminar to be held in conjunction working during one of the debates at the posed standards. It was noted that there with the winter symposium in January. winter symposium. The idea would be may be consequences with reimburse- The topic will be on transplant finances to provide participants an opportunity ment if VCA is treated as an organ. and healthcare reform. He reported that to become better engaged in the pro- Mock Medicare Survey services are still gram by posting questions from mobile Ad Hoc Committee being provided and there was discussion devices to include Twitter, Facebook, on Living Donation regarding further development of post- texting and other social media. He re- Dr. Andrew Klein reported that the Medicare survey consultative services. ported that RSS feeds are now available committee has been involved in work- Dr. Axelrod reported that the committee through the ASTS websites and en- ing with the OPTN/UNOS in develop- is developing a proposal for a leadership couraged the council to sign up for the ment of the guidance on the kidney development program for senior clini- automatic feed that will highlight new medical evaluation and liver medical cians and administrators. A potential for- information posted to the website. evaluation. Guidance targeted to the mat would be a short residential program lay public for living kidney and liver and subsequent teleconference teaching Curriculum Committee donors is in development and the ASTS in cooperation with an academic business Dr. Elizabeth Pomfret reported that is working in collaboration with the school. Finally, Dr. Axelrod proposed a total of 90 presentations have been OPTN/UNOS. Finally, he reported the that the committee prepare a white paper captured and are either in the test site
6 Chimera Winter 2010 www.asts.org for review by staff or available online in the desire to incorporate widely used lines for Controlled DCD Organ Pro- the Academic Universe. She reported immunosuppressive regimens into the curement and Transplantation” were that dedicated staff has been hired to active comparator arms of clinical trials, published in the September issue of the increase the momentum and expedite the possibility of using observational AJT. He reported that the committee is further implementation. The council data as part of the submission process attending regular Surgical Quality Alli- requested that an awareness campaign for new labeling indications, and the ance (SQA) meetings and that the com- to promote the curriculum be developed fact that AB-equivalent generics can be mittee is developing a “how to” primer and that visibility be increased that the approved without experience in a single on Pay for Quality Reporting Initiative curriculum is branded as the Academic transplant recipient. Drs. Archdeacon (PQRI) bonuses for the membership. Universe now that a sufficient number and Albrecht were extremely recep- Other long-term initiatives include for- of modules are available to members. tive to ASTS comments and outlined mulation and approval of transplant spe- a number of mechanisms for ASTS to cific performance measure for PQRI and Ethics Committee become more involved with FDA to exploring the pros and cons of obtaining Dr. Alan Reed reported that the manu- pursue these initiatives through FDA approval of the SRTR as a reporting reg- script, “Stimulus for Organ Donation: Public Workshops, data submissions, istry for PQRI. Finally, he reported the A Survey of the American Society of and potentially even legislative changes committee is working in collaboration Transplant Surgeons Membership” was in the Food and Drug Act. A number of with a group of liver transplant anesthe- published in the September issue of AJT. members of the Executive Committee siologists regarding analysis of a survey. He reported that the “ASTS Response commented that this highly productive to the Declaration of Istanbul” was ac- interchange marked yet another mile- Scientific Studies Committee cepted for publication and that two stone in continuing efforts to reach out Dr. David Gerber reported that the sessions at ATC on ethics have been constructively to regulatory agencies committee is working on an analysis of submitted to the program committee. that affect ASTS members’ practices financial implications of the Medicare Finally, he reported that a joint task and patients’ lives every day. ASTS will regulations with a preliminary focus on force with the AST was formed to re- continue to lead the way on behalf of expenses related to Quality Assurance view conflict of interest policies for joint members on these issues. and Performance Improvement (QAPI), projects including ATC and AJT. donor advocates, increase in personnel Fellowship Training Committee and frequency of Medicare surveys. The Federal Drug Ms. Kim Gifford, on behalf of Dr. John committee is also developing a proposal Administration (FDA) Magee, presented recommendations for for an initiative on HCC recurrence One of the highlights of the New York approval of reaccreditation applications, post-liver transplant. meeting was a session with representa- fellowship certificates for graduating fel- tives of the FDA. This was a follow-up lows and a post fellowship exit survey Vanguard Committee to the highly successful session at this that the committee has initiated. She Dr. Randall Sung presented highlights year’s ATC meeting. ASTS council reported that the 3rd Annual Fellows of the upcoming ASTS 2010 State of members and committee chairs had the Symposium will be held in Scottsdale, the Art Winter Symposium to be held opportunity to interact with Dr. Patrick Arizona in November. Finally, there at the Harbor Beach Marriott in Ft. Archdeacon, joined by Dr. Renata Al- was discussion regarding resident rota- Lauderdale, Florida. The theme is “The brecht, also from the FDA Center for tions and the possibility of them becom- Cutting Edge of Transplant Surgery” and Drug Evaluation and Research (CDER). ing an elective as part of general survey the Pre-Meeting will be “Clinical Re- They presented an informative over- training. The ASTS is committed to search in Transplantation.” He advised view of CDER, and also described the continuing to advocate for mandatory that the abstracts will be published in Center for Biologics Evaluation and transplant rotations and to demonstrate a special issue of the AJT as a supple- Research, and the Center for Devices improvement in the resident experi- ment in January. Dr. Sung presented an and Radiological Health. Each of these ence. Finally, there was discussion on outline for the 2011 winter symposium three FDA centers has responsibil- the need to include hepatobiliary train- on “Transplantation at the Crossroads” ity for important aspects of transplant ing as part of ASTS accredited liver fel- which received a positive response from therapeutics, diagnostics, or organ lowship training programs. the council. The location for 2011 will preservation technology. There was a be the Westin Diplomat Hotel in Hol- candid discussion about concerns ASTS Standards Committee lywood, Florida. has raised regarding what constitutes Dr. David Reich reported that the “adequate and well controlled studies”, “ASTS Recommended Practice Guide- www.asts.org Chimera Winter 2010 7 Regulatory and Reimbursement Update Is Your Transplant Center Accurately Capturing All Organ Acquisition Costs?
Medicare reimburses transplant centers charged to the transplant center and in- menting and allocating costs for an for the costs of organ acquisition but cluded in its organ acquisition costs. employee is time studies. Medicare does the rules dictating which costs qualify not require employees to keep daily time are complex and the documentation Non-Medicare Patients records, but does require that the time requirements often seem daunting. For For patients who are privately insured, study cover a full week per month and this reason, many transplant centers do physicians can submit a claim to a private that different weeks are used for consecu- not accurately capture their organ acqui- insurer for evaluations of donors and tive months. Some transplant centers sition costs. The following summarizes recipients rather than having those costs allocate a supervisor’s time based on the the types of costs that Medicare cat- treated as organ acquisition costs. The time studies of the employees being su- egorizes as organ acquisition and offers transplant center will lose Medicare re- pervised and allocate administrative staff guidelines on Medicare documentation imbursement, however, because Medicare based on the time studies of transplant requirements. only pays a portion of total organ acquisi- directors. These are general principles tion costs on the assumption that all organ and transplant centers should contact Physician Services acquisition costs, for Medicare beneficia- their Medicare fiscal intermediary to get Typical Medicare organ acquisition ries and other patients, are included in the approval of specific allocation methods. costs are tissue typing, preservation and total. Medicare uses a proxy to determine perfusion, registration with a transplant its share of total costs (the ratio of Medi- The use of time studies, rather than daily registry, and purchasing and transporting care organs to total organs), and if charges time records, creates concerns for physi- an organ. In addition, physician services for privately insured patients are not cians, however, because of the federal to a donor or recipient can be treated included in total organ acquisition costs, Stark and anti-kickback laws governing as organ acquisition costs, depending Medicare will obviously be reimbursing payments between physicians and referral principally on when those services are less than it otherwise would be. entities. Those laws require any payments provided. Medicare considers physician between a physician and entity to which costs for services to a live donor that are Transplant Center Costs the physician refers be at fair market val- provided prior to admission for the exci- For the transplant center’s services to a ue. If a physician employed part-time does sion to be organ acquisition costs which live donor, all services are considered or- not keep daily time records, it is difficult should be charged to the transplant cen- gan acquisition, even after the patient is to document the payments made to the ter rather than billed separately to Medi- admitted to the hospital for the excision. physician are at fair market value. Both care. For physician services provided to Postoperative hospital services to a live the hospital and physician are liable if the the donor after the donor is admitted for donor for complications from the dona- payments are found to be excessive and the excision, including post-operative tion are also considered organ acquisition therefore an inducement to make referrals. follow-up, Medicare dictates that the costs. For the recipient, Medicare treats physician’s services be billed as other hospital services furnished prior to the Medicare also requires separate reporting physician charges, except they are billed transplant as organ acquisition, but pays for each type of organ, so if the program to the account of the transplant recipient under a DRG for services furnished after director works in several transplant pro- at 100% of the fee schedule. (No copay- admission for the transplant. For hos- grams, the transplant center has to sepa- ments are billed to the donor.) Simi- pital services related to a deceased donor, rate the costs among the organs. Medicare larly, physician charges furnished to the all costs are organ acquisition. generally allows transplant centers to allo- recipient prior to the admission for the cate costs among different organ programs transplant are treated as organ acquisition Medicare also treats the transplant cen- based on the ratio of a particular type of costs, but after admission, are billed like ter’s administrative costs as organ acquisi- organ transplanted to total transplants. other physician charges. For a cadaver tion costs, such as salary and office costs excision, all physician charges are consid- associated with the transplant program Although Medicare rules related to organ ered organ acquisition costs. director. One difficulty in capturing acquisition are fairly complex, transplant these types of administrative costs, how- centers are obligated to report their costs Many physicians and transplant centers ever, is separating organ acquisition costs accurately on the Medicare cost report. In do not treat physician costs for physicals from other costs. Typically, a program addition, more accurate reporting may lead and other medical evaluations for a donor director has responsibilities associated to additional Medicare reimbursement. or recipient as organ acquisition. How- with the entire transplant process, not ever, any physician services furnished to just organ acquisition. By Barbara Straub Williams, Esq. a Medicare beneficiary prior to admission Powers Pyles Sutter and Verville, PC (for an excision for a live donor and for Documenting Costs Contact Ms. Williams a transplant for the recipient) should be The most reliable method for docu- at [email protected]
8 Chimera Winter 2010 www.asts.org Regulatory and Reimbursement Update Final Physician Fee Schedule Rule Will Boost Medicare Payment for Transplant Surgery in 2010
On October 30, 2009 the Centers definition of “physician services” for CMS finalized its proposals with respect for Medicare and Medicaid Services purposes of computing the physician to beneficiary eligibility for this new (CMS) posted the final 2010 Physi- update formula. This change will reduce benefit (Stage IV CKD as kidney dam- cian Fee Schedule Rule, which sets the number of years in which physicians age with a severe decreased in GFR de- forth final payment rates for 2010. are projected to experience a negative fined quantitatively as GFR of 15-29ml/ Under the Rule, Medicare payment update. min/1.73 m2 using the Modification of for the physicians’ services involved in Diet in Renal Disease Study formula). transplantation will increase, assuming Elimination of Consultation Codes: CMS also finalized its proposal to require that Congress once again acts to block CMS has finalized its proposal to elimi- KDE to be provided face-to-face and be implementation of any conversion factor nate all of the inpatient and outpatient given by a physician or other qualified reduction. consultations codes (except for certain person, which could include a PA or telehealth consultation codes), and will NP and, in rural areas, could be certain Implementation of AMA/RUC do so in a budget neutral manner. The institutional providers such as hospitals, Physician Practice Expense Survey: At agency will redistribute the work RVUs skilled nursing facilities or home health CMS’ direction, the American Medical for these services to other evaluation and agencies. Significantly, the KDE cannot Association, together with the medical management services, including new be provided by a renal dialysis facility. specialties, funded and implemented a and established office visits and initial CMS also finalized the content areas for survey on physician practice expenses. hospital and initial nursing facility visits. education set forth in its proposed rule, This survey, undertaken in 2007-2008, Significantly, the Final Rule indicates and limited coverage to six sessions per was designed to replace the outdated that the redistribution will increase pay- beneficiary with a length of 60 minutes. SMS survey from 1995 that CMS had ment for visits included in the global been using in its Physician Fee Schedule surgical package, although the agency Physician Self Referral (Stark) law: calculation. The survey yielded new observed that the impact on payment was CMS has finalized two clarifications practice expense per hour (PE/hr) or minimal. of the regulations implementing the each specialty as well as new data on physician self-referral law (Stark Law). direct to indirect cost ratios. Recalculation of Malpractice RVUs: The first provision clarifies that, even CMS is proposing a new methodology though the direct compensation excep- The Final Rule will phase in the new designed to more accurately capture tions will apply, it is not necessary for survey results over four years, to cushion malpractice costs by specialty. CMS each physician owner of a practice to the impact on specialties whose PE/hr estimates the impact of this as a positive sign every agreement with an entity that decreased. As reflected in the attached 1% for General Surgery and 2% for Car- provides services covered by the law. table, this change will increase Medicare diac/Thoracic Surgery. The malpractice The second clarifies that, when applying payment for all of the transplant codes changes appear to benefit transplant the Stark prohibitions to a group medi- in 2010 and each year throughout the surgery. cal practice, the parties must analyze transition (ending in 2013). whether the compensation payable to Chronic Kidney Disease Education: the practice takes into account refer- 2010 Conversion Factor to Decrease MIPPA included a new coverage provi- rals or other business generated by the As expected, the proposed by 21.2%: sion for chronic kidney disease educa- practice as a whole, including all owners, rule includes an estimated 2010 conver- tion (KDE) which provides for coverage employees, and independent contractors sion factor update of -21.2 % as a result of KDE for beneficiaries diagnosed with of the practice. It is not sufficient to look of the flawed SGR formula. Therefore, Stage IV CKD who will require dialysis simply at the relationship of compensa- CMS estimates the 2010 Medicare Phy- or a kidney transplant. tion from the DHS entity to referrals by sician Fee Schedule (MPFS) conver- the physician owners of the practice. sion factor will be set at approximately CMS is proposing to establish two G $28.4061 unless Congress acts to pre- codes for KDE which would describe These changes highlight that a physi- vent it, which appears likely based on one sixty minute education session. cian who is a part owner of a practice is the health care reform proposals cur- There is one code for individual educa- now strictly liable under the Stark law rently pending in Congress. tion sessions and another for education for the arrangements of the practice, in a group setting. In the Final Rule, even those involving other physicians, Removal of Part B Drugs from SGR CMS adjusted the amounts payable for and even though the physician may not Update Formula: CMS has finalized the service to reflect the one-hour time have been in a position to control or its proposal to remove Part B (i.e., limit for each service. influence the arrangement. physician-administered) drugs from the www.asts.org Chimera Winter 2010 9 Regulatory and Reimbursement Update
Immunosuppressive Drugs; Revision to Regulations to Conform to Statute: Please Note... CMS is revising its regulations to re- flect amendments to the Medicare law New for 2010! from several years ago which extended coverage for immunosuppressive drugs post-transplant provided the individual Abstracts accepted for oral, mini-oral or poster presentation at is otherwise Medicare eligible. This is not a substantive change. It simply con- the ASTS 10th Annual State of the Art Winter Symposium will forms the regulations to the governing be published in a special supplement to the American Journal statute. of Transplantation (AJT) to be shipped with the January issue. Please visit www.asts.org for more information.
Impact of 2010 Medicare Physician Fee Schedule on Transplant Services % 2009 2010 2013 RVU Change CPT/ Total Total Total 2010 2013 change 2009- HCPCS Status Description RVUs RVUs RVUs Payment Payment 2009-2010 2010 32851 A Lung transplant, single 69.64 71.98 71.24 $2,591.28 $2,564.64 2.34 3% 32852 A Lung transplant with bypass 77.05 79.65 78.52 $2,867.40 $2,826.72 2.6 3% 32853 A Lung transplant, double 83.33 85.82 84.9 $3,089.52 $3,056.40 2.49 3% 32854 A Lung transplant with bypass 90.6 93.78 92.86 $3,376.08 $3,342.96 3.18 4% 33935 R Transplantation, heart/lung 95.78 98.57 97.92 $3,548.52 $3,525.12 2.79 3% 33945 R Transplantation of heart 125.31 136.11 137.73 $4,899.96 $4,958.28 10.8 9% 47122 A Extensive removal of liver 86.82 90.68 94.59 $3,264.48 $3,405.24 3.86 4% 47125 A Partial removal of liver 77.77 81.16 84.7 $2,921.76 $3,049.20 3.39 4% 47130 A Partial removal of liver 83.62 87.2 90.83 $3,139.20 $3,269.88 3.58 4% 47135 R Transplantation of liver 122.99 128.79 134.48 $4,636.44 $4,841.28 5.8 5% 47136 R Transplantation of liver 104.89 110.01 115.14 $3,960.36 $4,145.04 5.12 5% 47140 A Partial removal, donor liver 86.92 93.16 97.79 $3,353.76 $3,520.44 6.24 7% 47141 A Partial removal, donor liver 103.09 103.55 107.18 $3,727.80 $3,858.48 0.46 0% 47142 A Partial removal, donor liver 113.3 123.23 129.06 $4,436.28 $4,646.16 9.93 9% 47146 A Prep donor liver/venous 8.57 8.81 9.13 $317.16 $ 328.68 0.24 3% 47147 A Prep donor liver/arterial 10 10.26 10.64 $369.36 $383.04 0.26 3% 48552 A Prep donor pancreas/venous 5.9 6.35 6.55 $228.60 $235.80 0.45 8% 48554 R Transpl allograft pancreas 61.61 65.5 69.16 $2,358.00 $2,489.76 3.89 6% 50320 A Remove kidney, living donor 37.09 38.13 38.64 $1,372.68 $1,391.04 1.04 3% 50327 A Prep renal graft/venous 5.52 5.87 6.01 $211.32 $216.36 0.35 6% 50328 A Prep renal graft/arterial 4.85 5.13 5.23 $184.68 $188.28 0.28 6% 50329 A Prep renal graft/ureteral 4.79 4.89 4.83 $176.04 $173.88 0.1 2% 50340 A Removal of kidney 22.93 24.24 25.61 $872.64 $921.96 1.31 6% 50360 A Transplantation of kidney 62.61 66.71 69.97 $2,401.56 $2,518.92 4.1 7% 50365 A Transplantation of kidney 71.57 75.1 77.99 $2,703.60 $2,807.64 3.53 5% 50370 A Remove transplanted kidney 29.24 31.12 32.52 $1,120.32 $1,170.72 1.88 6% 50380 A Reimplantation of kidney 49.39 52.78 54.16 $1,900.08 $1,949.76 3.39 7%
10 Chimera Winter 2010 www.asts.org Legislative Report Health Care Reform Endgame
On October 29th, the House Democratic Stalemate on Permanently leadership released health care re- Fixing the Medicare Physician form legislation (H.R. 3962) with the Payment Formula intent to bring a bill to the House floor Due to a cost of approximately $245 with enough votes to pass. The bill billion over ten years, a permanent would expand coverage to 96 percent physician payment fix has been stripped of Americans. The bill, entitled the from the House health reform legislation “Affordable Health Care for America to keep the cost of the reform bill Act,” includes a public insurance option under $900 million, President Obama’s with negotiated provider reimbursement stated goal. Instead, House Democrats rates (rather than Medicare rates). The introduced separate legislation to fix the bill would totally reform the private physician fee schedule and will schedule insurance market, making organ donor a separate vote on that bill. status and other health experiences irrelevant to the ability to purchase Under the new physician payment private insurance. In addition, all those legislation, H.R. 3961, the Medicare with incomes less than 150 percent of Physician Payment Reform Act of 2009, the federal poverty level (FPL) would the sustainable growth rate (SGR) formula qualify for Medicaid, compared with 133 of Medicare’s physician payment system percent in the original House bill and The gross cost of the House’s health care would be replaced with a new formula in the Senate legislation. The bill also legislation is $1,055 billion between comprised of two new growth rates that creates health insurance “exchanges” 2010 and 2019 with a net cost, after remove certain items, such as drugs and and provides significant federal subsidies subtracting revenue from taxes and laboratory services not paid directly to to purchase coverage. Finally, the bill fees, of $894 billion, according to the practitioners, from spending targets. The includes an ASTS-championed provi- Congressional Budget Office (CBO). two new growth rates would allow the sion extending immunosuppressive drug The bill is forecasted to reduce the fed- volume of primary and preventive care ser- coverage for Medicare beneficiaries. eral deficit by $104 billion over ten years vices to grow at the same rate as the Gross but increase federal health care expendi- Domestic Product (GDP) plus 2% per year To pay for the overall expanded insur- tures relative to other federal spending while allowing the volume of most other ance coverage, the bill includes a 5.4 by $598 billion over the next decade. physician services to grow at the rate of percent surtax on high-income house- The bill would still leave 18 million GDP plus 1% per year. holds with adjusted gross incomes over people without coverage, including $1 million and $500,000 for individuals. millions of illegal aliens. With respect The new bill will be considered in the These limits were increased significantly to the public option, CBO forecasts that House under a procedure which will from the original House bill which cre- approximately six million Americans add the text of H.R. 2920, the Statutory ated the surtax at $350,000 for families would enroll in this new public program. PAYGO Act of 2009, as passed by the and $280,000 for individuals. The House on July 22, 2009 before the whole House bill cut the amount that medi- The House is expected to begin debate package is sent to the Senate. After cal device manufacturers would pay to of the bill the first week of November. watching the Senate fail to consider offset the cost of health reform from In the Senate, Majority Leader Reid similar physician fee schedule legislation $40 billion over ten years to $20 billion (D-NV) has taken over melding the without providing the means for paying for through a 2.5 percent excise tax. The two Senate bills into a single package the new payment changes, House Speaker House bill also significantly increased for floor consideration. Reid has not Pelosi and Majority Leader Hoyer (D-MD) cuts in payments to the pharmaceutical announced when the new bill will be announced that legislation providing a industry, from $80 billion in the Senate released but is expected to begin the separate physician payment bill would not bill to more than double that figure in Senate debate on health reform at some be acted on in the House unless it does not the House bill. A large portion of this point in November 2009. The goal is add to the budget deficit or was enacted sum will pay for an accelerated elimina- for both chambers to finish their work along with a legislative package reinstating tion of the “donut hole” under Medicare in time for a final bill to be negotiated a pay-as-you-go budget law. The timing Part D drug plans. by both chambers and presented to the of this vote is difficult to predict but it is President before January 2010. expected before January 1, 2010. www.asts.org Chimera Winter 2010 11 Legislative Report
All of this comes after the Senate on government over ten years, adjusting it donation. ASTS strongly supports the October 21, 2009 resoundingly failed from an original $1 billion at the begin- elimination of organ donor status as a to pass a $247 billion, unpaid-for bill ning of the year, to $400 million this pre-existing condition and will work to sponsored by Sen. Stabenow (D-MI) summer, to a net $100 million savings ensure that the final health care reform that would have cancelled a 21 percent in the current House bill. This is largely legislation contains this protection for Medicare payment cut for physicians due to recalculated assumptions by CBO living donors. in 2010, replacing it with a freeze for and to coupling the provision with 10 years. Senate Majority Leader Harry another provision that bundles ESRD Funding for HRSA Division of Reid (D-Nev.) said the Senate will read- treatments which thereby have a mate- Transplantation Programs dress overall physician payment reform rial impact on the cost of the immuno- HRSA’s Division of Transplantation after health care reform legislation is suppressive provision. This new CBO is the federal office that oversees the finished. In the meantime, the Senate estimate is encouraging and makes the OPTN and runs the organ donation and Finance Committee health care reform task of keeping the House provision in transplantation programs authorized bill would implement another 1-year the final bill that goes to the President by the Organ Donation and Recovery delay that increases doctors’ pay by 0.5 less difficult. Improvement Act of 2004. When the percent in 2010 at a cost of $10.9 bil- Senate Labor/HHS Appropriations lion, with a 25% cut to the fee schedule Many of the ASTS leadership, including Subcommittee passed its bill in late July, in 2011. President Robert Merion, MD as well it included an increase of $2 million in as members of the ASTS Legislative fiscal year 2010 to fund DoT programs Immunosuppressive Drug Committee, have personally contacted over the current funding level of “Coverage Extension” their Senators and Members of Congress approximately $25 million. Legislation seeking their support for including these ASTS has long supported H.R. 1458 bills in the final health reform package Earlier this year, Senator Dorgan (D- and S. 565, the Comprehensive to be passed this year. Current ASTS ND) championed an amendment in the Immunosuppressive Drug Coverage for legislative focus is on getting the Senate Senate Budget Committee to increase Kidney Transplant Patients Act of 2009. to adopt Sen. Durbin’s (D-IL) bill, DoT funding by $10 million and the Under these bills, transplant recipients S. 565, as an amendment to the final amendment was adopted. While this pay the Part B premium, and Medicare Senate health reform bill during floor amendment was non-binding, it helped coverage of immunosuppressive drugs debate. set the stage for the $2 million increase would be extended beyond 36 months in DoT appropriations for fiscal year only for recipients who lack access to Pre-Existing Condition 2010. This increased Senate funding other coverage. All other health care Exclusions and Living Organ level must still be reconciled with the needs for transplant recipients not Donor Status House bill, which level funds DoT for Medicare aged or disabled would remain All of the health care reform bills pend- FY 2010 at this year’s level (i.e., ap- subject to the current ESRD 36-month ing in Congress would achieve another proximately $25 million). ASTS con- coverage limit. Only immunosuppres- major goal of the ASTS; prohibition tinues to spearhead this issue by pressing sive drugs would be covered for the of the use of living donor status as a House appropriators to adopt the Senate life of the transplant under this legisla- pre-existing condition in the private funding proposal and by working with tion. These limitations were necessary health insurance market. In fact, not other transplant organizations for ad- to reduce the cost of the legislation. only living donor status, but all health ditional support. ASTS, working with other transplant conditions, claims experience, and dis- organizations, succeeded in having these abilities would be prohibited from being Prepared by Peter W. Thomas, ASTS provisions included as Section 1232 of used in the issuance or rating of health Legislative Counsel, and Adam R. the final House health care reform bill. insurance. For living organ donors, Chrisney, Senior Legislative Director, these provisions would eliminate the Powers Pyles Sutter & Verville, PC Much of ASTS’ focus this fall has been problem that some live organ donors on securing a similar provision in the face when trying to access affordable Senate health reform bill and on miti- private health care insurance after they gating the provision’s cost. Interestingly, have donated an organ. This would the Congressional Budget Office (CBO) be a significant advance for live donors has continued to recalculate how much and remove this disincentive to live this provision would cost the federal
12 Chimera Winter 2010 www.asts.org OPTN/UNOS Corner
Board of Directors Meeting/ 2, the Board of Directors empowered Monthly online notice Slate of Nominees the OPTN/UNOS Executive In another initiative suggested by The OPTN/UNOS Board of Directors Committee to act on a proposal to end member feedback, UNOS plans to met November 16-17 in Orlando, the OPTN policy requiring prospective begin in January 2010 providing FL, after the submission date for this HTLV testing for deceased donors. a monthly, consolidated email edition. An executive summary of all After reviewing public comments communication to members. Routine Board actions will soon be available sought on the proposal, the Executive member notices and announcements on the OPTN web site: http://optn. Committee resolved that effective will be combined into a single online transplant.hrsa.gov. January 1, 2010, neither prospective document distributed on a regular nor retrospective HTLV testing shall date each month. The topics will The Board approved a slate of nominees be required for deceased donors. HTLV be organized to allow the reader to for open positions for its 2010-2011 testing for deceased donors may still quickly identify and view the most term. The nominees are listed on the be performed on an optional basis relevant items. Occasionally a OPTN web site. OPTN/UNOS voting according to the judgment of the separate email may need to be sent representatives will receive election bal- member institution and the availability on an urgent matter, but the monthly lots in early 2010. of testing. In addition, OPTN policy communication should greatly reduce continues to require prospective HTLV the overall number of broadcast emails CPRA Implementation testing of all living donors. UNOS currently sends. In October, the use of the Calculated Panel Reactive Antibody (CPRA) was Policy Rewrite Initiative Revised UNOS Web Site/Social implemented for kidney, pancreas and Member surveys and other member Media kidney-pancreas allocation, replacing feedback have long noted the complex Early in 2010, UNOS will launch a current and peak Panel Reactive wording and organization of OPTN revised version of its corporate web site. Antibody (PRA) for candidates listed policies. To address this concern, The site address will remain the same: for these organs. UNOS is beginning a major initiative http://www.unos.org. It will emphasize to rewrite OPTN policies for plain UNOS’ functions and core capabilities CPRA is the percentage of donors language and logical organization of as well as non-OPTN services and expected to have one or more of the information. This effort should not functions such as Transplant Living, unacceptable antigens indicated on the affect the substance or interpretation Tii, the National Donor Memorial, waiting list for a specific candidate. The of any policy, although the appropriate CreativeAid, and the UNOS CPRA is calculated automatically when committee(s) may review any policy Foundation. Content that is primarily the candidate’s unacceptable antigens questions or concerns identified related to the OPTN will be redirected are listed or updated. The CPRA is through this process. The process is with links to the OPTN site. derived from HLA antigen/allele group also intended to establish clarity and and haplotype frequencies for the differ- organizational standards for future In addition, UNOS has in recent ent racial/ethnic groups in proportion policies. months established a presence in social to their representation in the national media outlets. UNOS has a corporate deceased donor population. The project will involve two phases: page on Facebook, as well as Facebook The first phase will address policies not groups for Transplant Living and the Sensitized candidates will be assigned specific to organ allocation, and the sec- National Donor Memorial. In addition, four allocation points if they have de- ond will address organ-specific policies. UNOS maintains Twitter sites for the fined, unacceptable HLA antigens that An external advisory group representing UNOS Foundation, Transplant Living yield a CPRA of 80 percent or greater. a cross-section of OPTN members will and the National Donor Memorial, Each transplant center may define ad- assist UNOS staff, and UNOS will seek as well as YouTube channels for the ditional criteria for antigens it considers public input on the revised language National Donor Memorial and the as contraindications for transplantation. during each phase. The OPTN/UNOS UNOS Foundation. Please visit these Board is scheduled to consider all policy sites and encourage others interested in HTLV Testing for rewrites in November 2010. Look for transplantation to do so as well. Deceased Donors additional information about this proj- Given the discontinuance of the ect in early 2010. most common test to assess potential deceased organ donors for HTLV 1 and www.asts.org Chimera Winterr 2010 13 Academic Universe
Have you visited the ASTS procurement, ethics, and economics their mission statement below. ASTS and organ specific topics including and the Curriculum Committee Academic Universe? immunosuppressive strategies, rejection, are dedicated to the advancement outcomes and long-term follow-up. of all professionals in the field of Over 100 ASTS members have taken In the coming months ASTS and its transplantation and we hope you will advantage of this educational resource constituents will see the curriculum login today to experience the resources and we encourage you to login today expand rapidly with the planned within the ASTS Academic Universe. to experience another great benefit of addition of a new HPB unit. Be sure the membership. To access the Academic check back often as the areas of study The mission of the Curriculum Committee Universe, you must be logged in to are growing and changing each week. is to develop and implement the National the ASTS website; from the members’ Transplant Surgery Fellowship Curriculum. homepage, click on the banner or select Those who use the curriculum are given The curriculum will be designed to provide “Academic Universe” from the left all the tools to maximize their learning. a structured educational and training navigation bar. The Academic Universe brings the framework for abdominal transplant information right to the learner’s surgery fellowship. The curriculum will The National Transplant Surgery fingertips; you are able to learn from the provide Program Directors with a basis Fellowship Curriculum is housed within leaders in the field of transplantation for planning instruction and evaluating the Academic Universe. Modules are without leaving the comfort of your own fellows, designing program practices and submitted from physicians and other location. Each module is spearheaded assessing educational outcomes. The health care professionals from across by a narrated presentation on a specific National Transplant Surgery Fellowship the country. Bringing together so many topic and accompanied by a written Curriculum will guide fellows in their individuals to create such an expansive summary, suggested readings, and self- course of study and define key areas of curriculum is no easy task but the assessment to gauge learning. knowledge necessary for mastery of the field existing results already prove the value of transplant surgery. of such efforts. There are currently At the core of the ASTS mission is its sixty-two modules online with seventy- dedication to career-long education. - ASTS Curriculum Committee eight presentations covering general This mission is mirrored by the Mission Statement topics such as basic pharmacology, organ Curriculum Committee as seen in
14 Chimera Winter 2010 www.asts.org National Living National Living Donor Assistance Center Update Donor NLDAC Unveils New Web-Based Application Assistance Center Visit: www.livingdonorassistance.org
he National Living Donor center tab. To save time, this registra- Also, stay up-to-date on the latest TAssistance Center (NLDAC) is tion information automatically com- NLDAC program updates by join- excited to announce the unveiling of pletes the first step of the application. ing the NLDAC monthly electronic its brand new web-based application Applications may be started and then newsletter mailing list. Contact the system. This web-based application was saved to be completed at a later date. NLDAC office at 703.414.1600 or developed by Transplant Informatics A total of six transplant professionals [email protected] for Institute (Tii), a subsidiary of UNOS, per transplant program are allowed to more information. and provides a high level of security. register and file applications. The National Living Donor Assistance The application is easily accessed Registered filers will have access to all Center is funded by a federal grant, online through the NLDAC website NLDAC forms, worksheets and infor- awarded to the University of Michigan www.livingdonorassistance.org and was mational material needed to complete and the American Society of Transplant designed with the busy transplant pro- and submit an application. NLDAC Surgeons by the Department of fessional in mind. staff provided training to transplant Transplantation (DoT), Health and professional via a series of 30 minute Human Services (HHS) and adminis- Application filers must first register conference calls held in November tered by the Health Resource Service before they can file a NLDAC web- and December. Transplant center staff Administration (HRSA). based application and their registra- that were unable to attend one of these tion account must be activated by calls can still receive training by calling NLDAC staff is available Monday – NLDAC staff. To register, go to NLDAC and scheduling a one-on-one Friday 9:00-6:00 p.m. ET www.livingdonorassistance.org and select training sessions for their transplant team “filer registration” from the transplant members.
ASTS History Corner
Dear ASTS Members,
The great part of serving our ASTS members as your historian is the fun in putting together many pieces of a puzzle which ultimately will emerge as a coherent picture of our past. Our history is so rich that we are now pausing to “catch-up” with our Chimera Chronicles project and some opportunities to further edit and refine all of the video tapes soon to be available on our website. We expect to continue building the Chimera Chronicles video library either in May of 2010 or January of 2011.
In our January 2010 Winter Symposium meeting, Dr. Nicholas Tilney will present the first Annual David Hume Lecture sponsored by the American Foundation for Donation and Transplantation (AFDT). The AFDT was founded by Dr. Hume in Richmond, Virginia, as the Southeastern Organ Procurement Foundation (SEOPF) in 1969. AFDT has been a great partner in development of this lectureship which will honor Dr. Hume and his pioneering work in organ transplantation. We hope to build a yearly tradition honoring Dr. Hume with a lecture by a distinguished senior surgeon putting modern transplantation surgery in the perspective of past achievements.
Please take time to visit the ASTS website where the Chimera Chronicles, Great Stories in Transplant Surgery, documents our past and celebrates recent events. Click on photo library and see candid shots from our Fellows Symposia as well as the State of the Art Winter Symposia for the last several years.
Please feel free to contact me for any projects which might hold your interest in terms of expanding our great history and celebrating those pioneers who are still with us. And, stay tuned!
Thomas G. Peters, MD, FACS ASTS Historian
www.asts.org Chimera Winter 2010 15
A S T S 1 0 t h Annual State of the Art Winter Symposium
Look for these icons when Poster Session with Mini Oral planning your itinerary: Presentations S C R H A T S = Surgeon Moderators: Timothy L. Pruett, MD C = Clinician and Vincent P. Casingal, MD R = Researcher H = Allied Health Professional 3:45 – 5:00 PM A = Advanced Transplant Poster Session with Mini Oral Provider Presentations T = Trainee Career Development Seminar: Friday, January 15, 2010 1:25 – 1:45 PM The Art and Science Plenary Session Facial Composite Tissue of Public Speaking T S C R H A T Allotransplantation: New Era in Moderators: Michael J. Englesbe, MD Moderators: Robert M. Merion, MD Transplant Surgery and Julie K. Heimbach, MD and Randall S. Sung, MD Maria Siemionow, MD, PhD 5:00 – 6:30 PM Cleveland Clinic Foundation 12:00 – 12:05 PM Program Director & Division Chief Welcome 1:45 – 2:05 PM Forum: RRC Issues S Randall S. Sung, MD I Gave You Everything: Small Bowel 5:00 – 6:30 PM University of Michigan Cluster Transplant David F. Mercer, MD, PhD ASTS Winter Symposium 10th 12:05 – 12:25 PM University of Nebraska Medical Center Anniversary Reception Surgeons, Christmas Lights and 6:30 – 7:30 PM Cheerleaders Vanguard Award Presentation Mitchell L. Henry, MD Moderators: Robert M. Merion, MD Saturday, January 16, 2010 Ohio State University and Randall S. Sung, MD Surgical Techniques Case Presentations Panel 12:25 – 12:30 PM 2:05 – 2:10 PM S C R H T Introduction: The David Hume Award Presentation Includes interactive audience response Lecture session Thomas G. Peters, MD Keynote Speaker Session Moderator: Mitchell L. Henry, MD Shands Jacksonville Transplant Center S C H A T Moderators: Mitchell L. Henry, MD 8:00 – 8:05 AM 12:30 – 12:50 PM and Randall S. Sung, MD Welcome & Introduction The David Hume Lecture Mitchell L. Henry, MD As Time Goes By: The Evolution of 2:10 – 2:25 PM Ohio State University Transplantation Setting the Stage Nicholas L. Tilney, MD Robert M. Merion, MD 8:05 – 8:35 AM Brigham & Women’s Hospital University of Michigan Liver Case Julie K. Heimbach, MD 12:50 – 1:10 PM 2:25 – 3:25 PM Mayo Clinic Rochester Derivation of the Uncontrolled DCD With or Without You: Organ Protocol for New York City Procurement Teams Should Be Panelists: Stephen P. Wall, MD Regionalized Alan N. Langnas, MD NYU Langone Medical Center Pro: Kenneth R. McCurry, MD Kim M. Olthoff, MD University of Pittsburgh Medical Center Igal Kam, MD 1:10 – 1:25 PM Break Con: Ronald W. Busuttil, MD, PhD University of California, Los Angeles 8:35 – 9:05 AM Moderators: John P. Roberts, MD and Kidney Case Dorry L. Segev, MD 3:25 – 3:45 PM Break Paolo R. Salvalaggio, MD, PhD University of Washington Schedule of Events
A S T S 1 0 t h Annual State of the Art Winter Symposium
Panelists: Oral Abstract Presentations Paul C. Kuo, MD S C R H A T Arthur J. Matas, MD Moderators: Michael M. Abecassis, Mikel Prieto, MD MD, MBA and Ty B. Dunn, MD, MS
9:05 – 9:35 AM 9:15 – 10:45 AM Pancreas Case Oral Abstract Presentations David A. Axelrod, MD Dartmouth Medical School 10:45 – 11:00 AM Break
Panelists: State of the Art Presentation Hans W. Sollinger, MD, PhD Con: A. Osama Gaber, MD S C R H A T James F. Markmann, MD, PhD The Methodist Hospital/Cornell Moderator: James D. Eason, MD Dixon B. Kaufman, MD, PhD University Introduction 9:35 – 10:00 AM Break 12:30 – 1:00 PM Boxed Lunch James D. Eason, MD Methodist University Hospital/University Oral Abstract Presentations Vanguard Committee Mentorship of Tennessee S C R H T Reception Moderators: Peter G. Stock, MD, PhD 5:30 – 7:00 PM Award 11:00 – 11:30 AM and Hoonbae Jeon, MD Presentation Ceremony: Dancing in the Dark: The Future of Francis Moore Excellence in Immune Monitoring and Individualized 10:00 – 11:15 AM Mentorship in Transplantation Immunosuppression Oral Abstract Presentations Surgery Award Philip F. Halloran, MD University of Alberta 11:15 – 11:30 AM Break Dinner 7:00 – 10:00 PM Debates Mechanical Support Candidates S C R H A T and Donor/Organ Devices Moderators: Goran B. Klintmalm, S C A T Sunday, January 17, 2010 MD, PhD and Julie K. Heimbach, MD Moderators: Charles M. Miller, MD Surgical Video Presentations and Gregory J. McKenna, MD S C H A T 11:30 AM – 12:00 PM Moderators: Losing My Religion: UW is Superior to 11:30 – 11:50 AM Gonzolo Gonzales-Stawinski, MD and HTK for Abdominal Organ Preservation Bridge Over Troubled Water: ECMO Kristin L. Mekeel, MD Pro: Dorry L. Segev, MD to Lung Transplantation Johns Hopkins University Bartley P. Griffith, MD 7:25 – 7:30 AM Con: John J. Fung, MD, PhD University of Maryland Medical Center Welcome Cleveland Clinic Foundation Gonzolo Gonzales-Stawinski, MD 11:50 AM – 12:10 PM Cleveland Clinic Foundation 12:00 – 12:30 PM Cold, Cold Heart: Non-Renal Ex- Leaving on a Jet Plane: Deceased VIVO Perfusion 7:30 – 9:00 AM Donor Livers Should Be Regionally James Guarrera, MD Video Presentations Allocated Columbia University Medical Center Pro: Elizabeth A. Pomfret, MD, PhD 9:00 – 9:15 AM Break Lahey Clinic Medical Center 12:10 – 12:30 PM Con: Anthony M. D’Alessandro, MD Debate - All Night Long: Every Kidney University of Wisconsin Hospital Should Be Pumped Pro: Mark H. Deierhoi, MD University of Alabama – Birmingham
Save the Date ASTS 11th Annual State of the Art Winter Symposium: Transplantation at the Crossroads January 14 – 16, 2011 • The Westin Diplomat, Hollywood, FL
A S T S 1 0 t h Annual State of the Art Winter Symposium
Thursday, January 14, 2010 – 2:30 PM – 4:45 PM Friday, January 15, 2010 Cell Transplant Seminar: Islets in the Sun, Progress in Cell Transplantation Pre-Meeting: The last decade has seen remarkable achievements in cell transplantation. In the face of these, the use of cell based Clinical Research in therapies for diabetes, liver failure and other degenerative diseases remains complex, highly regulated and Transplantation* challenging. An appreciation of the issues, both scientific Educational Objectives: and administrative, is of great importance to transplant • Become conversant with the regulatory structure surgeons, who continue to lead and develop programs in in clinical research, specifically with respect to IRB this frontier of transplantation. This symposium, sponsored oversight, financial billing, and interactions with by the ASTS Cell Transplant Committee, will provide pharmaceutical companies apply the principles to an update on recent accomplishments and discuss the individual practices; challenges ahead. • Gain knowledge as to how to conduct an investigator- initiated clinical trial and how to participate in 5:00 PM – 6:30 PM multicenter trials; FDA and Transplantation Forum • Expand your knowledge of existing and new methods Representatives from the FDA Center for Drug Evaluation to develop database research programs within and Research (CDER) and Center for Biologic Evaluation individual practices and how to conduct single-center and Research (CBER) will provide an overview of FDA and registry based research studies; roles and responsibilities as it relates to solid organ • Improve competence regarding the elements of transplants. This session will provide opportunities for translational research, including biomarker research open dialogue and interaction with the FDA as it relates and tissue repositories applying knowledge in to advancing the field of transplantation through clinical individual practices; trials. • Study the potential impact of the current oversight of transplant programs at individual practices and Friday, January 15, 2010 strategies to mitigate barriers to innovation in 7:30 AM – 10:30 AM transplant clinical research with the goal of improving Business Practice Seminar: patient care. Understanding Transplant Finance and Health Care Reform * Additional registration fee required for this event. Educational Objectives: Thursday, January 14, 2010 • Improve knowledge of transplant center revenue 12:00 PM – 2:15 PM streams and how they impact individual practices; Vascularized Composite Allografts Seminar • Improve competence in understanding reimbursement Vascularized Composite Allografts (VCA) refers to the codes such as RUVs, CPTs and DRGs and apply within non-autologous transplantation of peripheral tissues the professional setting; including skin, muscle, nerve, and bone as a functional • Gain an understanding of key issues in professional fee unit (e.g. a hand) to replace non-reconstructible tissue coding and collection through systems-based practice defects. Although the technical methods for VCA have that can be applied in individual practices; followed logically from methods for limb replantation, • Understand how key issues in transplant contracting unique aspects of VCA have prevented its broad impact personal practices and strategies to improve application despite a large potential clinical need. The processes; focus of this seminar will be on specific issues related to • Become more informed about national healthcare VCA including regulatory matters, immunosuppression, reform and how to apply payment policies in individual and clinical applications. practices. Additional Events
18 Chimera Winter 2010 www.asts.org
A S T S 1 0 t h Annual State of the Art Winter Symposium
10:30 AM – 11:30 AM Saturday, January 16, 2010 CMS Regulations and Compliance Forum 8:00 AM – 11:15 PM Representatives from the Centers for Medicare and Medicaid Advanced Transplant Provider Session Services Clinical Standards Group and the Survey and Certification Group will provide updates on the transplant Educational Objectives: center regulations and compliance. This session will provide • Gain knowledge about the evaluation algorithm and opportunities for open dialogue and interaction with CMS as it contraindications for living liver donation and how relates to Medicare regulations and reimbursement. to incorporate procedures into individual practices within the context of current ethical debates; 5:00 PM – 6:30 PM • Learn the technique for percutaneous biopsies and Career Development Seminar: The Art and Science of how to perform and evaluate them in individual Public Speaking, Tips From a Pro practices in order to diagnose acute rejection and See a master teacher in action and learn how to polish your improve patient outcomes; presentation skills. It’s not enough to know your subject mat- • Improve knowledge regarding the controversies ter inside and out. How you deliver your message is equally surrounding the enrollment of patients in clinical important. Scott C. Litin, MD, MACP, Professor of Medicine trials and how to manage these cases in individual at the Mayo Clinic, will share tips that are certain to enhance practices; your presentation skills. Learn how to pace your presentation, • Improve performance through in-depth study of beginning with a compelling opening and ending with a strong familial amyloidotic polyneuropathy (FAP), its closing. Be aware of body language that can either enhance symptoms and identification of indications for or detract from your presentation. Learn technical tips that transplantation in a patient with FAP that allows for separate amateurs from professionals. Apply the skills you’ll implementation in individual practices; learn from Dr. Litin to make your next presentation go better • Improve Competence in indentifying and treating than your last. PTLD in individual practices through case studies.
5:00 PM – 6:30 PM 5:30 PM – 7:00 PM Faculty, Program Directors & Division Chief Session: Vanguard Committee Mentorship RRC Issues: Improving the Resident Experience in Cocktail Reception & Award Presentation:
Transplant Surgery Francis Moore Excellence in Mentorship Additional Events in Transplantation Surgery Award Educational Objectives: For the third year in a row, the Vanguard Committee • Learn about national issues pertaining to surgical residents will honor two recipients of the ASTS Francis Moore on transplant surgery rotations and potential impact on Excellence in Mentorship in Transplantation Surgery future training; Award. This award recognizes outstanding mentorship • Improve competence through strategies for improving the of fellowship trainees and junior faculty. The presenta- resident experience on transplant surgery rotations; tion will take place during the Vanguard Committee • Gain knowledge of level-specific learning objectives for Mentorship Cocktail Reception. This reception is residents on transplant surgery rotations and how to designed to develop and foster the academic careers of incorporate into individual resident training programs to junior surgical leaders. improve competence 7:00 PM – 10:00 PM 6:30 PM – 7:30 PM Symposium Dinner ASTS Winter Symposium 10th Anniversary Reception Relax, unwind, and network with peers and colleagues! Join us as we celebrate 10 years of providing state of the art Relaxed business attire is requested. Dinner is open to all science at the winter symposium! Spouse/Guest and children registered ASTS attendees. Spouse/Guest and chil- must be registered separately to attend this event. Registration dren must be registered separately to attend this event. badges will be checked upon entrance into this event. Registration badges will be checked upon entrance into this event.
www.asts.org Chimera Winter 2010 19 ASTS 3rd Annual Surgical Fellows Symposium Scottsdale, AZ, November 12-14, 2009
t the core of the ASTS mission is its commitment to define Aand promote training and provide career-long education to its members; the annual surgical fellows symposium is a shining example of how we meet that mission. This three day symposium is specifically designed for second year transplant fellows to focus on frequently cited gaps in fellowship training including aspects of transplant immunology, immunosuppression, candidate pre-evaluation, organ allocation, organ offers, long-term patient management, and education. ASTS thanks Astellas, Roche and Bristol-Myers Squibb for their support of this important educational activity. Team Belzer prepares for the case study session “Whatever you learn, pass it on.” Noorul Hasan Khan, MBBS, MS Mount Sinai School of Medicine
The experience and knowledge of the faculty members were definitely passed on to the fellows who attended the 3rd Annual Fellows Symposium in Scottsdale, Arizona. Lectures ranging from long-term management of transplant patients, to common post- transplant infections to procurement Audience response system tests fellow knowledge pitfalls, the fellowship symposium seemed to have it all, and having it all Dr. Chavin joins the liver case study debate was just what the doctor ordered. Final Answer? During lectures, faculty used “The symposium embodies the audience response system to ask questions that tested the very best of the mission the fellows’ knowledge and of ASTS. It’s interesting, decision-making skills. The fun, and the faculty answers were then displayed on the big screen so fellows gets to see the future of could see how their views transplantation face to compared to others. Many fellows said it was a great way face.” of showing how fellows from Charles Miller, MD around the country responded Cleveland Clinic Foundation Dr. Merion, ASTS President to difficult situations in transplantation.
20 Chimera Winter 2010 www.asts.org To Tweet or not to Tweet It was an idea from the Planning Committee that came into fruition. Fellows (and a few enthusiastic faculty) texted questions to a designated cell phone, which were displayed and answered by the lecturer. The second day, they put their networking skills to the test and posted questions on the ASTS facebook account and the final day “tweeted” questions on the ASTS Twitter page. Fellows said using these three forms of communication will really open doors to future ASTS networking abilities.
“It makes you think of all Symposium Participants the different approaches and Case and Point techniques other transplant Each day the fellows had a working lunch surgeons have. I didn’t think which divided them it would be this excellent!” into small groups, Yusuf Gunay, MD guided by faculty Ohio State University members, to discuss case studies. At the As we packed our bags and bid adieu end of the day, these to Arizona, we will all look back at the case studies would 3rd Annual Fellowship Symposium and be up for debate remember the words of Dr. Michael and appointed Abecassis during his lecture Leading Your team leaders would Transplant Team, “A transplant team is a go head to head mosaic of people who are different from arguing their point. Team leaders discuss the case studies each other but share the same destiny.” Faculty also joined in these debates, which made it all the more memorable Special Thanks... “It was a fantastic for fellows. opportunity to meet and Special thanks to the symposium collaborate with other “A different perspective planning committee! transplant fellows with a from various faculty across John C. Magee, MD similar environment who the country is always an Program Advisor can relate to our fellowship educational and eye-opening Sunil K. Geevarghese, MD, MSCI, experience.” experience.” Program Chair Arvand Elihu, MD Nabil Dagher, MD Thomas E. Collins, MD Stanford University Johns Hopkins Medical Center Planning Committee Jonathan P. Fryer, MD Planning Committee www.asts.org Chimera Winter 2010 21 Abdominal Transplant Surgery Fellowship Match Match Program The American Society of Transplant Surgeons (ASTS) is the sponsoring organization for the Abdominal Transplant Surgery Fellowship Match conducted via the National Resident Matching Program (NRMP). Visit www.asts.org and www.nrmp.org for detailed information concerning the Match.
Application Process The application process is independent from the Match and unique to individual institutions. Transplant Fellowship Programs use their individual application and interview process to evaluate potential transplant fellowship candi- dates for their programs. For a list of ASTS accredited Abdominal Fellowship Train- ing Programs visit www.asts.org.
Registering for the Match Transplant Fellowship Programs and Applicants must register for the Match. More information about the Abdominal Transplant Surgery Fellowship Match & other programs focused on advancing surgical care in trans- plantation can be found on the ASTS website, www.asts.org. Schedule for Match Conducted in 2010, Appointment Year 2011 January 13, 2010 Match Registration Opens April 14, 2010 Rank Order List Entry Opens May 26, 2010 Program Quota Change June 9, 2010 Rank Order List Closes Certification June 23, 2010 Match Day www.asts.org Chimera Summer 2009 23
ATC-10-Ad-825x10875-111709 1 11/17/09 3:37 PM Go For Gold...
ASTS Research Awards
Faculty Awards Resident/Trainee Awards Fellowship Awards
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 and its awards partners offered over $775,000 in fund- ing to ASTS members and their 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
Award notifications will be available by: April 2010 www.asts.org Order Now! TransplantationLiving Liver
videosASTS: Helping You Help Your Patients Creating Award Winning Educational Videos for the Transplant Community
Living Kidney Donation: What You Need to Know
Kidney Transplantation: A Guide for Patients and their Families
Ask About Spanish Versions
www.asts.org ASTS 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 at the time of printing. 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. 101 for submission guidelines and fee requirements.
Lehigh Valley Health Network: Piedmont Transplant Services: Lankenau Hospital: Kidney Transplant Surgeon and Clinical and Transplant Transplant/General Surgeon Director, Pancreas Transplant Hepatologist Please contact: Please contact: Please contact: James Lim, MD, FACS Michael Moritz, MD, Chief Cindy Baeder Program Director Transplantation Services, LVHN Manager of Physician Recruitment Lankenau Hospital Phone: 610-969-0213 Piedmont Medical Care Corporation 4404 Medical Sciences Bldg Email: [email protected] Email: [email protected] 100 Lancaster Ave Wynnewood, Pa 19096 The University of California The Center for Transplant Phone: 610-645-6403 Davis: Academic Transplant Services at The University of Email: [email protected] Surgeon Tennessee Medical Center, Please contact: Knoxville Swedish Medical Center in Alison Terry Please contact: Seattle: Organ Transplant Academic Personnel Manager Chris Marino Program Director UC Davis Health System - Director of Recruitment Please contact: Department of Surgery NHR Mike Waters Cypress Bldg., 3rd Floor Direct 800-647-2232 ext 202 Physician Recruiter 2221 Stockton Blvd. Local 954-532-0813 ext 202 Phone: 206-320-5962 Sacramento, California 95817-2214 Fax 866-328-1019 Email: [email protected] Email: [email protected] Website: www.nhrnationwide.com
In Memoriam: Charles F. Zukoski, MD
The American Society of Transplant Surgeons (ASTS) is deeply saddened at the loss of long time member and transplant pioneer Charles Zukoski, MD. Dr. Zukoski became a member of the ASTS in 1975. Injuries sustained in a car accident on August 23, 2009 resulted in his death.
ASTS recently honored Dr. Zukoski for his pioneering work in transplantation. Visit http://www. asts.org/Chimera, to view an abridgment of his Chimera Chronicles, Great Stories in Transplant Surgery interview.
Dr. Zukoski performed the first kidney transplant at Vanderbilt University in 1962, thus initiating clin- ical efforts at a program which has grown over five decades. Ultimately moving to Tucson, Arizona, he was an Emeritus Professor of Surgery at the University of Arizona College of Medicine. He is best known for pioneering work in immunosuppression. At the Medical College of Virginia, in laboratories of Dr. David Hume, Dr. Zukoski learned that azathio- prine and its derivative products would prolong kidney allograft survival in dogs. He served a long career in transplantation and general surgery at the Medical College of Virginia, Vanderbilt, North Carolina, and the University of Arizona. Dr. Zukoski was recognized by Vanderbilt in 2007 at the 45th Anniversary of the establishment of its transplant program.
Dr. Zukoski graduated from Harvard Medical School in 1951. He then completed an internship and residency at the Roosevelt Hospital in New York. Shortly after, he served as a Captain and Flight Surgeon in the U.S. Air force and completed a resi- dency at the University Hospital in Birmingham, Alabama.
26 Chimera Winter 2010 www.asts.org Corporate Support The American Society of Transplant Surgeons would like to thank the following companies for their generous support of the ASTS in 2009
Founder Circle
President Circle
Sponsor Circle
Associate Circle
www.asts.org Chimera Winter 2010 27 The Foundation of the
National Office 2461 South Clark Street Dear ASTS Members, Suite 640 Arlington, VA 22202 The American Society of Transplant Surgeons (ASTS) is proud to offer educational initiatives to influence Phone: 703 414-7870 transplantation, along with cultivating and advancing your career. As ASTS continues to grow, we are asking every member to become more involved because you are the key to combating the issues that threaten the prog- Fax: 703 414-7874 ress of transplantation. www.asts.org/ASTSFoundation This year began with triumphs for transplantation while recent headwinds have stifled a plethora of healthcare President resources. ASTS helped secure $10 million in funding for organ donation and transplantation (with antici- John P. Roberts, MD pated inclusion in the next Senate budget bill), and we maintain a robust annual awards program offering over Univ. of California San Francisco $775,000 a year to recipients, while transplant research received $200 million when the 2009 Recovery Act awarded funds to the National Institutes of Health for challenge grants. We ask that you remain confident that Vice President ASTS will remain dedicated to providing you with the best resources, programs, and training. Robert M. Merion, MD University of Michigan ASTS is one of the most sought after primary resources for the evolution and advancement of transplantation. In fact, NATCO, the Organization for Transplant Professionals, has partnered with ASTS to establish dual member- ship. This collaboration will provide both organizations with the opportunity to expand our efforts in the trans- Secretary/Treasurer plant community. Dozens of nurse practitioners and physician assistants have also joined the ranks. In recent years, Alan N. Langnas, DO the ASTS membership has amplified by over 20%, a testimonial that ASTS is doing something right! University of Nebraska You can expect continued commitment from the ASTS on: Immediate Past President . Funding transplantation research Goran B. Klintmalm, MD, PhD . Training and education Baylor Regional Transplant Inst. . Topic-driven symposia and consensus conferences . Development of business practice services and education, career development and strong advocacy on Board of Directors legislative and regulatory issues Michael M. Abecassis, MD, MBA . The American Transplant Congress (ATC) Kim M. Olthoff, MD . The # 1 journal in transplantation, American Journal of Transplantation (AJT) . Advancing the science and practice of transplantation Richard B. Freeman, Jr., MD Dixon B. Kaufman, MD, PhD We know that you care about receiving high quality information regarding training, legislation, regulatory, and Timothy L. Pruett, MD reimbursement issues that affect you, so now is the time to act. James D. Eason, MD Charles M. Miller, MD Contribute to the Foundation of the ASTS today. To make a gift by phone, please call 703.414.7870 ext 100, Peter G. Stock, MD, PhD online at http://www.asts.org/astsfoundation or use the enclosed envelope to make a one time or monthly contri- R. Mark Ghobrial, MD, PhD bution. Robert S. Higgins, MD, MSHA Elizabeth A. Pomfret, MD, PhD 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 or [email protected]. Attached is a list of ASTS programs and initia- Executive Director tives. Katrina Crist, MBA 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 on this calendar, please contact Chantay Parks Moye at 703.414.7870 ext. 101 or [email protected].
Online CME Activity: June 25-29, 2010 Managing Symptoms and Monitoring Progress Upcoming ASTS NATCO Introductory Education Course in the Graft Recipient: The Patient Perspective for the New Transplant & Procurement Release Date: May 22, 2009 Events Professional Expiration Date: May 22, 2010 Tempe Mission Palms Hotel Presented by Drs. Stuart Flechner and and Conference Center Matthew Weir Tempe, AZ Website: http://www.freecme.com/gcourse_ Telephone: 913 895.4612 view.php?course_id=8133 ASTS State of the Art Email: [email protected] Website: www.natco1.org January 2010 Winter Symposium January 15-17, 2010 January 15 -17, 2010 August 2010 NATCO Symposium for the Advanced The Cutting Edge of August 1-4, 2010 Transplant Professional Transplant Surgery Natco 35th Annual Meeting Harbor Beach Marriott, FL Westin Diplomat Resort & Spa Phone: 913 895.4612 Pre-Meeting: Clinical Research Hollywood, FL Email: [email protected] Telephone: 913 895.4612 Website: www.natco1.org in Transplantation Email: [email protected] (place URL in web browser) January 14-15, 2010 Website: www.natco1.org Harbor Beach Marriott February 2010 Ft. Lauderdale, FL October 2010 February 4-6, 2010 October 28-30, 2010 UCSD 29th Annual Advanced ITNS 19th Annual Symposium Nephrology: Nephrology for the Consultant American Transplant Congress and General Assembly La Jolla, CA May 1-May 5, 2010 Minneapolis, MN Email: [email protected] San Diego Convention Center Website: http://cme.ucsd.edu/nephrology/ San Diego, CA November 2010 November 5-9, 2010 February 4-7, 2010 NATCO Introductory Education Course th www.asts.org/Meetings 9 International Conference on New Trends in for the New Transplant Immunosuppression and Immunotherapy & Procurement Professional Kenes International Tempe Mission Palms Hotel Prague, Czech Republic April 2010 and Conference Center Website: www.kenes.com April 13–17, 2010 Tempe, AZ NKF 2010 Spring Clinical Meetings Telephone: 913 895.4612 February 7-8, 2009 Walt Disney World Swan and Dolphin Email: [email protected] Intestinal Failure: Latest Advances in Orlando, FL Website: www.natco1.org Diagnosis and Treatment Including Website: www.nkfclinicalmeetings.org Transplantation American Society for Parental May 2010 and Enteral Nutrition May 27–29, 2010 Las Vegas, NV ASAIO’s 56th Annual Conference Please Note... Website: www.nutritioncare.org Hilton Baltimore (Harbor), MD ASAIO Inc February 12-13, 2010 Telephone: 561 999.8969 Fax 561.999.8972 ITNS Winter Workshop Email: [email protected] Quality Issues & Best Practices in Transplant Website: www.asaio.com Nursing ASTS Council and Omni La Masion del Rio June 2010 Committee Chair Meetings, San Antonio, TX June 18-19, 2010 January 13-14, 2010 Website: www.itns.org nd ITNS 2 European Conference 2010 Harbor Beach Marriott Transplant Nursing, Improving Patient Outcomes Berlin, Germany Ft. Lauderdale, FL Website: www.itns.org www.asts.org Chimera Winter 2010 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]
Ahmad Abou Abbass, MD Truman M. Earl, MD Fady M. Kaldas, MD Henry Ford Health System Washington University St. Louis University of California Los Angeles
Peter L. Abrams, MD Mazen Elatrache, MD Ilhan Karabicak, MD University of Pittsburgh Henry Ford Health System New York University
Zeki Acun, MD Arvand Elihu, MD Lori M. Kautzman, MD University of Miami Stanford University University of Nebraska Medical Center
Andrew Adams, MD, PhD Ji Fan, MD Malgorzata Kloc-Stepkowska, PhD, DSC Massachusetts General Hospital University of Miami The Methodist Hospital
Mohammad AkhavanHeidari, MD Michael B. Filsinger, MPA, PA-C Michael D. Kluger, MD, MPH University of Pittsburgh Carolinas Medical Center New York Presbyterian Hospital
Jose L. Almeda, MD Amy E. Gallo, MD Sumana Kolar Ramachandra, MD University of Southern California Stanford University University of Pittsburgh
Lynsey S. Biondi, MD Harvey E. Garrett, MD Hussam Kudsi, MD University of Alabama Birmingham Cardiovascular Surgery Clinic Albert Einstein Medical Center
Pedro J. Briceno, MD Brian K. Goh, MBBS, MSc Susan Logan, MD Miami Transplant Institute Mayo Clinic Rochester Washington University St. Louis
Alex W. Cantafio, MD Christie W. Gooden, MD Bonnie E. Lonze, MD, PhD University of Washington Medical University of Michigan Health System Johns Hopkins University
Abhideep Chaudhary, MD Yusuf Gunay, MD Basant Mahadevappa, MBBS, MRCS University of Pittsburgh The Ohio State University Medical Westchester Medical Center
Yee Lee Cheah, MD Koji Hashimoto, MD, PhD Alexander T. Maskin, MD Lahey Clinic Cleveland Clinic Foundation University of Pennsylvania
Linda J. Chen, MD David G. Heidt, MD Nikole A. Neidlinger, MD University of Miami University of Michigan Health System University of Wisconsin
Jacob N. Clendenon, MD Peter J. Hodgkinson, MBBS, FRACS Eviatar Nesher, MD Mayo Clinic Florida University of Miami University of Miami
Nabil N. Dagher, MD Christine S. Hwang, MD Adena J. Osband, MD Johns Hopkins University Stanford University Robert Wood Johnson University
Jason E. Denny, MD, BS Jacques M. Jeudy, MD Kwan Tae Park, MD, PhD Henry Ford Health System Centre Hospitalier du Sacre Coeur, Haiti Asan Medical Center, Seoul, Korea
Kiran K. Dhanireddy, MD Christopher M. Jones, MD Rosina S. Perkins, MD University of California Los Angeles Ronald Reagan UCLA Medical Center University of Toronto It’s Truly A Great Time To Be A Member
30 Chimera Winter 2010 www.asts.org Trevor W. Reichman, MD, PhD Riaz A. Shah, MD Giridhar V. Vedula, MD Toronto General Hospital Rush University Medical Center New York Presbyterian - Columbia
George Rofaiel, MB, BCh Malay B. Shah, MD Jennifer E. Verbesey, MD Cleveland Clinic Foundation University of Alabama Birmingham Lahey Clinic
Antonio Romano, MD Pratima Sharma, MD, MS Anthony C. Watkins, MD University of Miami University of Michigan Health System Columbia University
Srinivas S. Samavedi, MBBS Pooja Singh, MD Vaughn E. Whittaker, MB, BS The Ohio State University Medical Thomas Jefferson University Hospital Columbia Presbyterian Medical Center
Ely M. Sebastian, MD Thomas S. Skelton, MD Aaron M. Winnick, MD University of Pittsburgh Medical Center The Methodist Hospital New York University
Motaz A. Selim, MBBCH, MSc Georgeine Smith, BS, MS, PA-C Radi F. Zaki, MD Mount Sinai Hospital Hospital of the University of Pennsylvania Albert Einstein Medical Center
Markus Selzner, MD Julio C. Sokolich, MD Monika Zwierzchoniewska, MD Toronto General Hospital University of Florida - Shands Hospital University of Rochester Medical Center
Natarajan Sezhian, MBBS, FRCS Parsia A. Vagefi, MD Cleveland Clinic Foundation University of California San Francisco It’s Truly A Great Time To Be A Member
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703.414.7870 www.asts.org www.asts.org [email protected] Winter 2010 31 ASTS National Office 2461 South Clark Street Suite 640 Arlington, 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