Coming to DonorNet® Dec. 15: Changes to notification limits for intestine, pancreas, kidney-pancreas and kidney matches

Audience

• Primary OPO Administrative Directors, Primary OPO Data Coordinators
• OPO Administrators, Data Coordinators, Organ Placement Coordinators and OPO/TXC Acceptance Call Consultants, Organ Procurement Adms/Mgrs
• Intestine, kidney and pancreas transplant Primary Program Administrators
• All UNet℠ users
• Please share this notice with anyone in your organization who would benefit from this information.

Implementation date:

• Dec. 15

At-a-glance

On Dec. 15,  there will be changes to how electronic organ offer limits in DonorNet® are applied for intestine, pancreas, kidney-pancreas and kidney matches in their respective distance-based allocation systems. Organ procurement organizations (OPOs) should review their settings to determine if updates are needed.

Background

OPOs are able to set limits for the number of electronic organ offers that can be sent simultaneously to local candidates and/or local programs. Historically, the system defined local offers as offers to programs within the same donation service area (DSA). As allocation policies transition away from the use of DSA and region, the term “local offer” is taking on new meaning. When DSA is no longer used as the first unit of allocation, candidates at the top of the match runs may include potential recipients who are beyond the DSA border.

OPOs can expect to see increases in the maximum number of potential recipients eligible to be notified simultaneously. This change affords OPOs more flexibility to make informed decisions about how to offer organs using their own defined best practices. Which organ offers will be controlled by the OPO-defined “local” limits varies by match type, and is shown below:

Summary of changes

• Intestine allocation became distance-based on Feb. 4, 2020.
• Beginning Dec. 15, intestine matches will use “local” organ offer limits when sending offers to candidates who are:
  • within the DSA, or
  • within 500 nautical miles (NM), or
  • listed as Status 1

• Kidney, pancreas and kidney-pancreas allocation becomes distance-based on Dec. 15.
• At that time:
  • Pancreas/Kidney-Pancreas matches will use “local” organ offer limits when sending offers to candidates who are:
    • within the DSA, or
    • within 250 NM, or
    • 0 ABDR mismatch with the donor and have a CPRA > = 80%

• • Kidney matches will use “local” organ offer limits when sending offers to candidates who:
    • Are within the DSA, or
    • Are within 250 NM, or
    • Fall into classification:
      • 1 through 39 on allocation sequence A (KDPI 0 -20% or enbloc)**
      • 1 through 29 on allocation sequence B (KDPI 21-34%)**
      • 1 through 28 on allocation sequence C (KDPI 35-85%)**
      • 1 through 22 on allocation sequence D (KDPI > 85%)**

**Refer to this policy notice for a full list of these kidney classifications, which will go into effect Dec. 15.

These changes to OPO electronic organ offer limits for intestine, kidney, pancreas and kidney-pancreas will bring the standards for OPO notification limits in DonorNet into a consistent framework for all organ types.  Corresponding changes have already been implemented for liver, heart, lung, and heart-lung match runs following the implementation of distance-based allocations for those organs.

These changes were developed in response to community feedback. An Organ Procurement and Transplantation Network workgroup that included donation and transplant members with experience in all organ types collaborated to develop these changes. Maintaining the use of DSA as part of local notification limits, in addition to distance and classifications, ensures minimal disruption in allocation practices. OPOs must still offer according to the match run, in the order of the match run, in line with OPTN allocation policies.

What you need to do

OPOs should review their current “local” organ offer notification limit settings in DonorNet to determine if updates are necessary.  It is recommended that OPOs communicate with intestine, kidney-pancreas, and kidney transplant programs that fall under the new definition of local offers to develop appropriate, efficient offering processes.

Additional resources

Find professional education on UNOS Connect:

• QLT102D Notification Limits for Distance-based Allocation

DonorNet online help documentation will be updated so that OPOs will have access to the information about how local limits are used for matches for all organ types.

Questions?

If you have questions relating to implementation, contact UNOS Customer Service at [email protected], or call 800-978-4334 from 8 am to 7 pm EST.

For policy-related questions, contact [email protected].

The Organ Center is available around the clock and can be reached at 800-292-9537.