Transplant Program Selection Guidelines
Solid Organ Transplant Requirements
NTN participation requires that each solid organ program meet the following requirements:
- Meet established annual volume requirements data as reported by the Organ Procurement and Transplantation Network (OPTN)
- Meet outcomes requirements data as reported by the Scientific Registry for Transplant Recipients
- 1 month and 1 year graft and patient survival must be within or above expected outcomes
- Any program that is below the expected outcomes for respective 1 month and 1 year categories must pass all components of the "3 prong test" outlined in the OPTN bylaws:
- Appendix B: Survival Rates
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Annual Minimum Volume Requirement
Pediatric volume information is attained from the Scientific Registry for Transplant Recipients, as reported for the 2.5 year period used to determine program performance, or from Organ Procurement and Transplantation Network, as reported for the preceding 2 years.
|Organ ||Adult/Year ||Pediatric/Period |
|Heart ||10 ||9 |
|Lung ||10 ||9 |
|Heart/Lung ||Heart and Lung programs must be approved ||Heart and Lung programs must be approved |
|Kidney ||10 ||9 |
|Pancreas ||Kidney program must be approved ||Kidney program must be approved |
|Liver ||10 ||9 |
|Intestine ||Liver program must be approved ||Liver program must be approved |
|Multi-Visceral ||Liver and Intestine Programs must be approved ||Liver and Intestine Programs must be approved |
Bone Marrow (Stem Cell) Transplant (BMT) Requirements
NTN participation requires that each bone marrow (stem cell) transplant program meet the following requirements:
- Adult and Pediatric Autologous BMT: 90% 100 day survival rate**
- Adult and Pediatric Allogeneic BMT: 70% 100 day survival rate**
- All participating programs must be accredited by the Foundation for the Accreditation of Cellular Therapy (FACT)
** Programs that perform less than 35 annual autologous or 35 annual allogeneic transplants will be required to submit data from the immediately preceding year's transplants in order to obtain a statistically significant number of transplant cases (35).
All Transplant Programs
Transplant programs that fail to meet NTN criteria will be suspended from network participation until such time that they meet NTN participation criteria. In most circumstances, members may remain at the facility under continuity of care provisions
Adult Transplant Programs Must be Medicare Certified
- Solid organ transplant programs will be reviewed twice annually, following the release of updated statistics from the Scientific Registry of Transplant Recipients (SRTR)
- All stem cell transplant facilities are required to perform both Autologous and Allogeneic bone marrow transplants, effective with contracts executed after 1/1/2007
- ASBMT statistics/forms notably the 100 day survival statistics must be received by NTN no later than October 1 of each calendar year (reporting volumes and outcomes of the previous calendar year). Failure to submit these statistics by October 1 of each year may result in immediate suspension of referral and authorization of new patients.
- All facilities must execute an NTN Agreement in order to participate in the National Transplant Network
The participation criteria listed above shall be effective with all credentialing and re-credentialing of participating providers on July 15, 2008.
These programs and tools are not insurance products and are not guaranteed under any contract. Humana is not required to provide these services, but makes them available to eligible members at no additional cost.