Resolution 5 Pancreas Transplantation Committee Jonathan Fridell MD Chair Serum lipase is a direct indicator of pancreas quality Serum lipase is not reported for all potential pancreas donors ID: 1034925
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1. Proposal to Require the Collection of Serum Lipase for all Pancreas Donors (Resolution 5)Pancreas Transplantation CommitteeJonathan Fridell, MD, Chair
2. Serum lipase is a direct indicator of pancreas qualitySerum lipase is not reported for all potential pancreas donorsThe Problem
3. Lipase is a pancreatic enzymes that catalyzes the hydrolysis of fatsElevated serum lipase is a marker of pancreatic injury or inflammationWhen PA injured or inflamed, lipase is released into the circulationUnlike serum amylase, lipase is more specific to the PA and the levels remain elevated longerMost essential test to evaluate PA quality for transplantWhy serum lipase?
4. Strategic Plan
5. Data
6. GoalProvide transplant professionals with critical information about the quality of the pancreas offeredChangeRequire collection of serum lipase for all pancreas donorsReport lab’s upper limit of normal value for serum lipase testHow the Proposal will Achieve its Goal
7. Public Comment Response TallyType of ResponseResponse TotalIn FavorIn Favor as AmendedOpposedNo Vote/No Comment/ Did Not ConsiderIndividual2617 (65.38%)N/A5 (19.23%)4 (15.38%) Regional1111 (100%)N/A0 (0%)0 (0%)Committee191 (5.26%)N/A1 (5.26%)17 (89.47%)Public Comment Feedback
8. Geographically remote OPOs may not be able to comply with serum lipase requirementSome OPOs’ labs do not run a serum lipase test Some OPOs’ labs currently run the serum lipase test once a dayQuestion whether serum lipase is a strong indicator of pancreatic quality Public Comment: Common Themes
9. Outreach to OPO Committee Pancreas Committee investigated numerous alternatives but none could be supported by both committeesPancreas Committee is recommending policy be approved with no post-public comment changesPost Public Comment Outreach/Follow Up
10. Overall Project ImpactAll pancreas donors, candidates, and recipients
11. RESOLVED, that Policies 2.11.E Required Information for Deceased Pancreas Donors are modified as set forth below, are hereby approved, effective pending programming and notice to OPTN membership. Resolution 5 (page 13)
12. Back-up Slides
13. Exception languageIf serum lipase results are not available at the time of the pancreas offer because the laboratory could not provide the results prior to the pancreas offer, the host OPO must do both of the following: 1. Report to the OPTN Contractor that the serum lipase results were not available at the time of the pancreas offer. 2. Provide serum lipase results to the transplant hospital as soon as they become available.
14. RESOLVED, that Policies 2.11.E Required Information for Deceased Pancreas Donors are modified as set forth below, are hereby approved, effective pending programming and notice to OPTN membership. Resolution 6 (page 14)
15. A closer look at the dataN = 4011 donors with no serum lipase reported on DDR, and PA not recovered for Tx
16. Suggestion that P-PASS score (which includes lipase) does not show impact on graft survival Pointed out that Pancreas Donor Risk Index (PDRI) does not include lipase as PA donor risk factorDetails About Other OPO comments