transplant atlantic november 4, 2016 tammy keough-ryan ... · transplant atlantic november 4, 2016...
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Future of kidney transplantation:
Transplant Atlantic
November 4, 2016
Tammy Keough-Ryan & Ian Alwayn
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Research
• Since 2011 (5 years) over 60 published manuscripts in peer-
reviewed journals
• Focus of much of this research is to look at existing practices
and determine how these can be improved
• Ischemia times
• Matching / risks
• Frailty
• BK virus
• Live donor outcomes
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Future of clinical research
• Dr. Karthik Tennankore
• Atlantic frailty in kidney transplantation project
• Dr. Amanda Miller
• Mismatch in kidney transplantation
• Dr. Christine Dipchand
• Live donor risks and outcomes
• + Atlantic collaborators!!!
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• Chris Daly
• Director of Clinical Research
• Laura Sills & Liz Larsen
• Research nurses & coordinators
• + Atlantic collaborators!!!
Future of clinical research
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• QEII Foundation Endowed Chair in Transplantation
Research
• Supports basic science – salary/infrastructure/collaborations
• Supports clinical science – match funding/investigator initiated
research
• + Atlantic collaborators!!!
Future of clinical & fundamental research
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Hypothermic machine perfusion: kidney
Moers et al, NEJM 2009
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Normothermic machine perfusion: kidney
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Xenotransplantation: kidney
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Xenotransplantation: kidney – CRISPR/Cas9
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Xenotransplantation: kidney – CRISPR/Cas9
Verbal communication: • More genes have been edited • Tested against kidney waitlist (Birmingham) • About to start clinical trial..
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Xenotransplantation: kidney
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Administration
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★
★
★
★
★
★
★
★
528,336 (NL)
754,735 (NB)
945,824 (NS)
146,933 (PEI)
2016 Stats from http://www.statcan.gc.ca
★
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Administration: loco-regional innovations??
• Amalgamation of health authorities…
• Priorities of Nova Scotian government…
• Optimizing collaborations within Atlantic region…
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Administration Program vs. Departmental vs. Divisional
Co Leadership
Multidisciplinary
Regional: 4 provinces, Multiple sites: Interprovincial Sharing
Understand individual organizational structures
Programs: Administrative Governance (DOH, ODO and Transplant, Renal programs), Clinical
Funding : investment variable and focus
Champions in each province……site
ATAC: Atlantic Transplant Advisory Committee
Provincial renal programs
Transplant Voice in strategic planning
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Administration Transplant first as treatment for end stage renal
disease for appropriate patients
Messaging supported through renal programs
Programs strategic planning
Provincial, regional and national objectives aligned
Shared focus/targets………..Realize ,maximize
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Administration
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Administration Budgets
Operational: “Memorandum of Understanding”
Management
Clinical and administrative
Complex donors, patients, national program
Satellite and central
Education
Academic program, training programs
Medications
Generics
High cost drugs
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MOTP Organizational Structure
VP
Integrated Health Services
Program care 1
MOTP Executive
Administrative
Assistant, MOTP
• Medical Clinical Services
• Medical Director Kidney Program
• Medical Director Pancreas Program
• Medical Director Liver Program
• Medical Director Heart Transplant
• Medical Director Lung transplant
• Medical Director Live Donation
• Transplant Clinic Services
• 6B inpatient Services
• Transplant Coordinators
• Support staff for MOTP
• MOTP IT
• MOTP Quality Leader
• MOTP Pharmacist
• Surgical Clinical Services
• Surgical Director Kidney Program
• Surgical Director Pancreas Program
• Surgical Director Liver Program
• Surgical Director Heart Transplant
• Surgical Director Live Donation
Atlantic Transplant
Advisory Council
VP
Medicine and Integrated
Health Services
Administrative
Co-Lead
Medical
Co-Lead
Surgical
Co-Lead
Executive Director
Central Zone
• Clinical Working Groups
• Academic Programs
• Quality
MOTP
Administrative
Co-Lead
Health Service Director
QEII
Central Zone Medical
Executive Director
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Administrative
Renal Wait List Committee
Satellite sites: meetings local
Central site: weekly meetings: teleconference or join by Lync technology
HLA Clinical meetings
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Administration: National innovations??
• Strong respresentation (kidney listed)
• KTAC
• Drs. Keough-Ryan (NS), Gogan (NB), & Barrett (Nfld)
• LDAC
• Dr. Christine Dipchand
• ODTEAC
• Dr. Ian Alwayn
• CST Board / subcommittees
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OTDT Program: Areas of Focus
Canadian Blood Services
24
Strategic Plan Development & Implementation
Canadian Transplant
Registry Programs &
Services
System Performance Improvement
Leading Practices,
Professional & Public
Education
Develop leading practices & provide awareness & education services
Timely & accurate data for reporting & system improvement
Policies review & feedback to guide national programs and services
KPD Program HSP Program NOW Program CTR Services
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Summary
• Strong research track record in Halifax
• Exciting innovations in organ transplantation!
• Innovations are typically transferrable to all organs
• Administration…interesting times…
• It’s all about engagement!!!
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MOTP
• Opportunities to Enhance Future “Quality”
• Clinical
• Growth
• Education
• AFC Program in SOT
• Distributive teaching
• Research
• Growth
• Quality of Care
• Administration
• Collaboration
• Internal and external
• Continuum
• Referral Listing Access (allocation) Transplant Post transplant transfer of care and follow-up (satellite and central clinics) Outcomes
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Thank you!