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PUBLIC POLICY REPORT FOR JANUARY, 2023

MEDICARE CHANGES FOR ESRD KIDNEY IMMUNOSUPPRESSION

After a years-long grassroots effort, changes to Medicare coverage of immunosuppression for ESRD patients goes into effect January 1, 2023. The coalition of patient advocacy group and organ-related organization such as the NKF carried the fight all the way through the Congress to seeing the White House sign the legislation.


This extension of immunosuppressant drug coverage under Medicare is intended for people who don’t have insurance or who aren’t older than 65 and already receiving Medicare. For an informative video explanation, see https://www.youtube.com/watch?v=0DfihOFKmzc


For all the information about the changes and how patients can start receiving the new benefit, please check out the following website: https://www.cms.gov/medicare/original-medicare-part-and-b-eligibility-and-enrollment/medicare-part-b-immunosuppressive-drug-benefit


If the link doesn’t work, copy and paste the link into a new browser window. You may also call Social Security at 877 465-0355.


PRODUCT EXPIRATION DATES

Most of us stay very vigilant about product expiration dates, be it cans or containers of food and certainly our medications. We check to see if a prescription drug or even an over-the counter item has expired beyond its use date.


And we’re all most likely very vigilant about the Covid test kits, to make sure the kit shelf life has not expired so that we feel confident about the results of the test. However, this isn’t the case with the Covid test kits currently available. The kits continue to be available under the FDA Emergency Use Authorization provisions. This means that the FDA is continuously evaluating expiration dates. Companies are still required to issue the test kits with lot numbers and expiration dates; then, the FDA maintains a website that continuously updates expiration dates by lot number. More information about this website can be found at the following: https://www.myast.org/joint-statement-about-covid-19-vaccination-organ-transplant-candidates-and-recipients-0


The statement summarizes the known scientific and medical evidence about vaccine safety and coverage for transplant patients.


WINTER ACHES AND PAINS

It’s difficult to keep track of all the aches and pains that occur when there’s so much going on to make us ill. Northwell Health, a very large hospital system based in Nassau County, New York, has recently published a chart on the various symptoms with COVID, the flu, colds, and RSV (the respiratory virus syndrome). The chart is a very good visual representation of all these diseases and how they manifest themselves. Of course, with all illnesses, please contact your own transplant team for your specific treatment.




ORGAN DONATION AFTER CIRCULATORY DEATH EXPANDS

The University of Chicago Medicine transplant team performed that health system’s first donated-after-circulatory death (DCD) heart transplant on Nov. 19, 2022. The DCD technique is expected to help heart patients get transplants faster. Donor hearts are traditionally recovered from brain-dead donors, a process known as donation after brain death (DBD). The donor meets the legal definition of brain death but has a beating heart. The organ is recovered while the donor's circulatory system is intact, which preserves the health of the heart.


In a DCD transplant, a patient may still exhibit brain reflexes, but the prognosis is poor – death is imminent. The family may choose to withdraw life support and allow the patient to pass. When the heart stops beating, and a waiting period verifies the heart will not restart, the heart is recovered for donation. The DCD procedure allows the family and registered donors to gift more life-saving organs.


The use of DCD organs is trending in the heart and lung transplant fields, according to Christopher T. Salerno, MD, Director of Adult Cardiac Surgery and the Surgical Director of the Heart Transplant and Mechanical Assist Device Program. UChicago Medicine already performs DCD lung transplants.


Using TransMedics OCS Heart technology, the donor heart is kept in a metabolically active state in a portable unit until it can be transplanted. Advances in technology and recovery procedures have increased the number of DCD organs, according to United Network for Organ Sharing (UNOS). “This technology allows us to get patients transplanted more quickly, saving lives and ensuring better outcomes,” Salerno said. The UChicago Medicine Heart Transplant Program currently has the shortest average wait time for a heart transplant in the country, 0.7 months compared to the national average of 4.9 months. UChicago Medicine is one of just 30 of the 147 U.S. heart transplant centers that performs DCD heart transplants. The increase in DCD donations is expected to provide an additional 600 donors nationally per year, Salerno said. Some reports say it can increase the heart donor pool by as much as 20%.

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