Geographic distribution efforts ongoing

• Liver distribution policy scheduled for April 30 implementation
• Thoracic and VCA proposals out for public comment
• Concept paper published for kidney and pancreas distribution
• Public comment deadline is March 22

A number of efforts continue to remove donation service area (DSA) and regional boundaries from organ distribution policies, consistent with the OPTN Final Rule and guidance adopted by the OPTN/UNOS Board of Directors.

The liver distribution policy, approved by the OPTN/UNOS Board in December 2018, is scheduled for implementation April 30.

The Thoracic Organ Transplantation Committee is seeking public comment on a proposal to replace DSAs, currently used as a local unit in heart distribution, with a radius of transplant hospitals within 250 nautical miles of the donor hospital. (Lung distribution policy has already been modified to use the radius of 250 nautical miles as the first level of distribution.)

The Vascularized Composite Allograft Transplantation Committee similarly invites public comment on a proposal to replace regional boundaries, currently used as the first level of VCA distribution, with a radius of transplant hospitals within 750 nautical miles of the donor hospital.

Both committees ask that if you recommend an alternate distance for consideration in public comment, please provide additional rationale and any supporting evidence to aid in their review. You may do so using the text field of the online response form, or contact the UNOS staff member(s) listed for each proposal.

The Kidney Transplantation Committee and Pancreas Transplantation Committee are co-sponsoring a concept paper for public comment regarding ways to eliminate DSA and regional boundaries from kidney and pancreas distribution. The paper summarizes the efforts of a workgroup composed of members from the two committees. It also summarizes key findings from SRTR modeling of alternatives considered by the workgroup. Your feedback is vital to support development of a policy proposal for public comment later in 2019.

The deadline for submitting public comment is Friday, March 22. Additional updates will be shared on the Geography in Organ Distribution resource page.