Regulatory Environment and Finances of Running a Pediatric Transplant Program

Abstract

Pediatric transplantation in the United States (USA) is subject to the same regulatory oversight through the Organ Procurement and Transplantation Network (OPTN) and the Center for Medicare and Medicaid Services (CMS) as adult transplant programs. Compliance with these regulations can be more challenging primarily related to volume. The volume of pediatric solid organ transplants within the USA is only 6% of the total volume of transplants performed. This low volume of procedures is spread across over 100 transplant programs, further diluting the aggregated volume within a single center. In particular staffing, maintenance of training and the ability to ensure staff competency is difficult when volumes are low. The financial operations of pediatric transplant programs are subject to a higher cost structure than their adult counterparts. Coupled with lower transplant volumes and poorer reimbursement through Medicaid, the finances of a pediatric transplant program can be significant. These challenges will be explored in this chapter.