CARE Tool helps hospital boost transplants

In early 2025, The Ohio State University Wexner Medical Center’s kidney surgeons voiced concern they were not receiving as many organ offers. Using the UNOS CARE Tool, Molly Maxwell, nurse manager of the abdominal transplant team, was able to quickly uncover the truth: Offers had not declined, but acceptances had.

The CARE Tool let Maxwell drill down on different variables to see surgeons were more likely to turn down kidneys that came from more than 250 miles away and that were greater than 100 in the offer sequence. The team looked at outcomes when these organs were transplanted elsewhere and realized they were declining some organs that did well in other patients.

Changing acceptance behaviors “has made a huge – I mean huge – difference,” she says. “You can see our transplant volume increased pretty significantly from that point on.”

She says the CARE Tools system map is “amazing” and allowed her to show that only  about 10% of Wexner’s kidneys came from more than 250 miles away, while comparable programs were accepting a higher percentage or organs coming from a similar distance.

The realization led the team to rethink transportation. Because the local airport in Columbus, Ohio, is not open 24-hours, they now consider other options. “Can we fly into Cleveland or Cincinnati and drive it?” she says.

Maxwell also uses the CARE Tool with heart and lung teams to look at declined organs that later resulted in successful transplants elsewhere. She says often, surgeons decline lungs based on their scans. Digging into these decisions with the CARE Tool, “helps validate some of the decisions,” she says, “but it also helps you see what you need to focus on.”

For Maxwell, the CARE Tool is essential for helping her teams understand offer patterns, identify missed opportunities and accept more organs for transplant. “I don’t know that we would be able to monitor offer acceptance at all without this tool,” she says.