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Important Information for Kidney and Liver Programs re: pre-transplant performance metric

Important Information for Kidney and Liver Programs re:  pre-transplant performance metric

Note: The CPM FAQ was recently updated in December of 2011. Read updated FAQ.

In June 2011, the Board of Directors approved a proposal to evaluate the merits of a new metric, the CPM. If adopted, the MPSC would use the CPM to evaluate pre-transplant performance.  Throughout a 12-month period, the MPSC will send a survey focusing on pre-transplant processes to a sample of kidney and liver transplant programs. The results of these surveys will help the MPSC determine if they should implement this metric as a performance monitoring tool.  The survey will not only help determine the usefulness of the metric, it will also increase awareness of the importance of tracking pre-transplant performance. The survey is still open for anyone that has been invited to participate.

What is CPM? 
The CPM (Composite Pre-Transplant Metric) is a single metric derived by combining the following SRTR-produced, pre-transplant performance metrics:  case-mix adjusted mortality rates, transplant rates, and acceptance rates.  In related but different ways, each of these metrics measures a transplant program’s ability to adequately serve the patients on its waitlist.  

The CPM can be thought of as an “aggregate, pre-transplant observed-to-expected ratio,” and is scaled in the same way as the metrics currently used to measure transplant programs’ post-transplant (graft and patient) survival. CPM values substantially greater than 1 may indicate the need for process improvement, whereas values less than 1 are considered better than expected and may reflect a best practice in waitlist management. 

The distribution of CPM among kidney and liver programs tends to look like this:

Right now organ and offer acceptance rates are available only for kidney and liver programs, so thoracic programs will not be part of the study. 

If you are contacted to participate in this survey, please respond within the time period requested.  Your participation will help the MPSC evaluate the usefulness of the metric and its ability to identify potential waiting list management issues. It will also help the MPSC codify the review process based on pre-transplant metrics, should they decide to adopt this new tool.   The survey is also your opportunity to provide feedback on the use of pre-transplant measures for performance evaluation.

The MPSC is not currently using CPM or its component metrics to monitor programs. Members will not face action based on data included in the letters sent to sampled centers during the study period; however, if your program participates in the study and is identified to have exhibited potential noncompliance with UNOS requirements based on information submitted in response to the study, your program may be referred to the MPSC for consideration. 

For more information on this metric, please review this FAQ document. You may also contact Jacqui O’Keefe in UNOS Membership at 804-782-4857 or via email at Jacqueline.Okeefe@unos.org.

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