COVID-19 and solid organ transplant

• COVID-19 offer refusal codes
• Changes to wait time initiation for non-dialysis kidney candidates
• Relaxation of TIEDI data submission requirements
• COVID-19 infectious disease testing in DonorNet
  • Report suspected transplant-related disease transmission

View more on COVID-19 policy actions

OPTN launches COVID-focused interactive collaborative project; donation and transplant professionals will be able to share insights, resources

The emergence of COVID-19 has brought unique challenges to some of the standard processes and practices related to organ recovery and transplantation. The Organ Procurement and Transplantation Network strives to support its members as they continue to pursue the important work of organ recoveries and transplants during this time.

The OPTN launched an interactive forum on April 22 so that its members may engage on topics specific to donation and transplant during COVID-19. The OPTN COVID Collaborative operates on a secure online communication platform and allows donation and transplant professionals to collaboratively discuss, organize, catalog and archive the learnings and insights developed during the 2020 pandemic.

The site will:

• Offer discussion forums, facilitated by collaborative improvement specialists
• House and organize the member-driven information that results from this collaboration
• Be available for the duration of COVID-19, or until the decision is made to close the project
• Deploy national and regional webinars to support the spread of effective practices that emerge from site discussion

Participation in the COVID Collaborative is limited to individuals from OPTN member organizations. Registration is required. The scope of discussions will include OPTN member business and administrative processes related to the management of COVID crisis, and discussions will be moderated. Members with questions about policy during the pandemic should email member.questions@unos.org. Members with questions about policy compliance during the pandemic should email MQFeedback@unos.org.

Participants will receive an email with account and login information.

Do you have an idea for a webinar or other insights to share? Email covidcollab@unos.org.

For more information about the OPTN COVID Collaborative, email covidcollab@unos.org.

In response to inquiries regarding COVID-19, the American Society of Transplantation’s Infectious Disease Community of Practice has developed recommendations regarding organ donor testing. This guidance reflects the current state of knowledge and involves questions pertaining to screening and testing of living and deceased donors in the COVID era. Learn more here.

• SRTR extends data review period deadline to May 31

The OPTN Membership and Professional Standards Committee leadership has evaluated specific areas of monitoring that are raising particular concern within the community. In an effort to encourage transplant programs to use their clinical judgement about what is in the best interests of their patients without the added concern of strict compliance with OPTN obligations, the MPSC will implement several time-limited emergency changes to member monitoring. These include:

• Suspending functional inactivity reviews through Sept. 30, 2020
• Placing temporary hold on reviews of patient notification of extended waiting list inactivity and transplant program inactivation through Sept. 30, 2020

All updates to monitoring changes may be found in a supplement to the OPTN member evaluation plan on the OPTN compliance page.

View list of time-limited monitoring changes

This document serves as a quick-reference guide to all member monitoring changes implemented as a result of the pandemic. It will be regularly updated with any additional monitoring changes implemented during this event.

Site surveys

Site surveys will be conducted virtually at least through the end of June, and any member who is not able to participate in a survey at this time can request a delay by emailing MQFeedback@UNOS.org. The MPSC and the Scientific Registry of Transplant Recipients will work together to make changes to the outcomes metrics that reflect the challenges of this unique environment. While we are determining how or whether to conduct reviews of this period, please continue to make the best clinical decisions regarding your donors and patients. We will provide updates as we have more specific information to share.

About MPSC and rationale for COVID-19 updates

The MPSC is a body of peers from within the donation and transplant community. It maintains membership criteria and monitors OPTN member compliance with OPTN membership criteria, OPTN bylaws and policies, and the OPTN Final Rule.

OPTN policies and requirements have not been suspended as a result of COVID-19. However, deviations from OPTN requirements will be evaluated in the context of the circumstances that have arisen due to this national crisis. The MPSC will look for a commitment to patient safety, stewardship of donated organs, and the rationale for the decisions that your transplant program or OPO make.

The OPTN is collecting information about challenges and issues created by the outbreak in order to evaluate further improvements or assistance that HHS, the OPTN and UNOS can provide. Please use this survey tool to report interruptions or issues. Please note that the link works in the Google Chrome browser, but it does not work in Internet Explorer.

Report COVID-19 issues

• AST
  • FAQ for organ transplantation
  • Recommendations and guidance for organ donor testing
• CDC COVID-19 website
  • Interim infection prevention and control recommendations
  • Morbidity and Mortality Weekly Report
• CMS adult elective surgery and procedure guidelines
• NAS Annual Meeting: Experts Discuss COVID-19 Pandemic and Science’s Response
• Transplantation Society COVID-19 website
  • Transplantation Society COVID-19 recommendations
• TTS COVID-19 Dashboard

• Report transplant candidate data
• Report cause of death for transplant candidates and recipients

• System modification to Waitlist^SM allows hospitals to reactivate liver candidates without having to update labs
• Reactivation process for multiple kidney transplant candidates now available
• Making candidates temporarily inactive
• Maintain wait time for inactive candidates
• Temporary COVID-19 precaution inactivation for multiple kidney transplant candidates

Inactivation FAQ and sample letters

• Inactivation FAQ
• Sample patient notification letter for programs that choose long-term inactivation
• Sample notification letter to the OPTN for programs that choose long-term inactivation

• AJT: “Coronavirus disease 2019: Implications of emerging infections for transplantation”
• AHA: “Challenges in heart transplantation in the era of COVID-19”

To the extent practical, continue to follow the match run. If transportation systems become disrupted and an organ cannot be transported to a hospital on the match run, use the 861 bypass code and proceed to allocate as high on the match run as logistics allow. These decisions should be based on the availability of transportation options, not on DSA or regional boundaries.

• Record donor COVID-19 testing and results data in DonorNet

• COVID-19 Weekly RUM Report now available in the Data Portal
• Refer to the AOPO informational resource addressing donor evaluation and OPO procedures in light of potential COVID-19 infection