St. Louis – The Board of Directors of the Organ Procurement and Transplantation Network, at its meeting Dec. 5, approved a set of actions to prepare for implementation of a new lung allocation policy based on continuous distribution, originally scheduled to take effect March 2, 2023. The lung continuous distribution policy is now expected to implement on March 9, 2023. The preparatory actions include revised guidance, guidelines and policy regarding the review process for exception requests, as well as an update to multi-organ allocation policy including lungs.
“The new lung allocation policy will be truly transformative,” said Jerry McCauley, M.D., M.P.H., president of the board. “We expect it to improve transplant access for the sickest patients and reduce deaths among those awaiting a transplant. The adjustments approved today will help ensure we are better prepared to launch the new system effectively.”
The board also affirmed a policy that provides an exception pathway for heart transplant candidates who have a mechanical circulatory support device that has been recalled. The OPTN Executive Committee initially had approved this pathway in July 2022 as an emergency action; the board’s action will continue it on a permanent basis.
In addition, the board approved the slate of nominees for the election of board members for open positions beginning July 1, 2023. The board also appointed Deanna Santana to complete a current term as an at large patient/donor affairs representative on the board to replace Merry Smith, M.B.A.
Other actions
The board took a number of additional actions as follows:
- Approved a process to modify kidney waiting time for candidates negatively affected by a race-inclusive calculation of estimated glomerular function rate
- Accepted updates to guidance for the National Liver Review Board regarding adult MELD and pediatric liver transplant candidates
- Endorsed a white paper prepared by the OPTN Ethics Committee regarding transparency in transplant program selection
- Approved updates and clarifications to policies relating to kidney paired donation
- Accepted enhancements to donor data collection in instances of donation after cardiac death (DCD)
- Approved an update to data collection to use in mortality models for lung allocation
- Accepted a resolution to extend transplant notification requirements to VCA program inactivation
- Approved additional refinement of categories of what are now termed “genitourinary organs” within vascularized composite allograft (VCA) policy
- Approved a nomenclature update to OPTN member certification requirements for histocompatibility laboratory directors
Discussion items
The board held a set of facilitated, small-group discussions to identify challenges with organ transportation logistics. The collective input will guide topic development and prioritization of future OPTN projects to improve logistical processes.
The board hosted additional discussion on the following initiatives:
- Updates on initiatives in progress to improve the organ offer process, including offer filters and predictive analytics
- A report from the OPTN Membership and Professional Standards Committee regarding new performance metrics, updated processes for peer review, and planned new communications to OPTN members about issues potentially affecting patient safety and/or compliance with OPTN requirements
- An update from the OPTN Finance Committee on recent financial activity and development of the fiscal year 2023 OPTN budget
- A report from the OPTN Data Advisory Committee regarding data submission, recommendations to improve data quality, and early results from the “data lock” initiative
- A briefing on the OPTN Policy Oversight Committee’s review and prioritization of OPTN project development
