Statement

The Department of Veterans Affairs (VA) is committed to providing the very best in quality
health care services to our Nations Veterans. VA provides comprehensive transplant care and
treatment to eligible and enrolled Veterans through a network of 1,055 outpatient clinics and 168
VA Medical Centers of which twelve are designated VA Transplant Centers (VATC). The
VATCs comprise the VA Transplant Program, which evaluates approximately 2,500 referrals
and performs more than 550 solid organ (heart, liver, lung, kidney) and bone marrow transplants
annually. VAs Transplant Program outcomes compare favorably to all United States Transplant
Centers as publicly reported by the Scientific Registry for Transplant Recipients (SRTR).
Background
The Veterans Health Administration provides oversight of the VA Transplant Program through
the National Surgery Office as described in VHA Directive 2012-018.
The VAs National Surgery Office (NSO) has established a secure, intranet-based system, named
TRACER, to facilitate the referral of the Veteran from a referring VA facility to the selected
VATC. TRACER also tracks the timeliness of VATC referral decision, evaluation, wait listing,
and transplant, as well as survival. The VA supports the VA Transplant Program through
telehealth and travel benefits for pre-transplant evaluation, the transplant procedure and posttransplant follow-on care, and treatment of the Veteran and living donor if applicable. Travel
benefits also apply to the Veteran's caregiver.
Published studies analyzing retrospective data show that the majority of transplant candidates,
both in and outside the VA, live considerable distances from a transplant center. The results of
these studies indicate that the time from referral to placement on the United Network of Organ
Sharing (UNOS) deceased donor organ wait list is less if the candidate lives within 100 miles of
the transplant center. For Veterans referred to the VA Transplant Program, further study would
be required to determine whether the implementation of TRACER, access to VA travel benefits,
and the utilization of telehealth have impacted the reported travel distance risk. However, it
should be noted that VA Transplant Program outcomes, including 1 and 3 year survival rates,
compare favorably to all United States Transplant Centers as publicly reported by the Scientific
Registry for Transplant Recipients (SRTR).
The VA has the authority to refer a Veteran for transplant care in the community in the case that the VA
Transplant Program is not feasibly accessible due to urgency of the services required or a VATC cannot
provide the medically necessary services required given unique circumstances. This authority extends to
the living donor as required.
In summary, the VA Transplant Program is well established and resourced to provide comprehensive
transplant services to Veterans enrolled in the VHA. Outcomes are favorable when compared nationally
by Scientific Registry of Transplant Recipients. When necessary, care in the community is available;
however, such outsourced care requires additional coordination of services while potentially negatively
impacting VATC utilization and efficiency.

Q. How much money is in the transplant special purpose funding pot each year?
A. In FY 2016, $77.6 million was budgeted for the Transplant Special Purpose
Fund. http://vaww.arc.med.va.gov/reports/vera/vera2016/final_vera2016/finalR_vera16_table1B
.htm