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5-Tier System Moving from Beta Site to Public Site

5-Tier System Moving from Beta Site to Public Site

MINNEAPOLIS ― January 16, 2019 ― In December 2016, SRTR launched a new website that displayed a new 5-tier outcome assessment for all transplant programs in the United States. This new system, which replaced a 3-tier system, was developed over a period of 5 years and approved by SRTR’s Visiting Committee (SVC). However, in response to community feedback, the 5-tier system was moved to a beta website in February 2017, and was replaced by the previous 3-tier system on the main SRTR website. The intent of the beta site was to allow for more feedback and to consider additional improvements.

After applying multiple improvements based on feedback received, SRTR also recently called for public comment on the beta site changes and collected additional feedback for a period of 60 days (May 14, 2018 to July 13, 2018). Changes were made in response to the feedback received, and SRTR is pleased to announce that after receiving both HRSA and SVC approval, the 5-tier outcome assessment system will be moving from the beta site to the public site on February 5, 2019.

In response to the feedback and SVC’s recommendations, changes made include:

1. Five-tier assessments for waitlist mortality and deceased donor transplant rate have been added, in response to feedback that the new system placed too much emphasis on first-year transplant outcomes. Additional feedback received advocated not to provide a waitlist mortality tier for kidney candidates because kidney programs do not care for candidates as directly as other organ types, so SRTR removed the waitlist mortality tier for kidney programs.

2. The transplant rate is now based on deceased donor transplants only, rather than on both deceased and living donor transplants, in response to feedback that the combined transplant rate was potentially misleading to patients without a living donor.

3. Living donor transplant counts for liver and kidney programs are now displayed alongside the deceased donor transplant counts, in response to feedback that the site should prominently display programs that perform more living donor transplants.

4. Various improvements to educational materials provided alongside the search results have been made, including 1) improved explanatory text for each outcome as determined through patient focus groups; 2) a key that shows expected outcomes for programs in each tier for waitlist mortality, transplant rate, and first-year graft survival; 3) an indicator showing which outcome has the greatest overall impact on survival after listing for each organ; 4) removal of interpretive text previously provided with each tier, e.g., “worse than expected,” “better than expected.”

You can currently view detailed information about these updates/changes on our beta site, and the 5-tier system will soon become available on the public website. These changes were made following feedback received from the community and vetted through patient focus groups and randomized trials of various website iterations during 2017 and 2018. SRTR continues to welcome feedback and is always looking for ways to improve the program assessments in place. Contact us with any questions or comments at srtr@srtr.org.

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