Dallas — The Board of Directors of the Organ Procurement and Transplantation Network, at its meeting December 6, approved new metrics for monitoring the performance of transplant programs. The new standards will be broader than the existing process, including assessment of both pre-transplant and post-transplant patient outcomes.
“Our monitoring process should be patient-centered and provide a more holistic view of patient care, and these measures will enhance those objectives,” said Matthew Cooper, M.D., president of the board. “Our goal remains to work with members to help them identify and implement opportunities for improvement. This will help programs optimize patient safety and high quality outcomes.”
The new process will evaluate two pre-transplant measures for each transplant program — the rate of pre-transplant deaths and the ratio of organ offers made to and accepted for candidates — as well as two post-transplant metrics — 90-day graft survival (an assessment of whether the transplanted organ is functioning) and one-year graft survival conditional to the 90-day period. Currently, one-year patient and graft survival are the only factors considered.
Other actions
The Board took a number of additional actions as follows:
- Approved a slate of nominees to election for open positions on the Board of Directors beginning July 1, 2022
- Approved the establishment of membership requirements for uterus transplant programs
- Adopted recommendations to modify data elements and collect new data fields on logistics of organ recovery and transportation
- Approved changes to reporting of immediate graft dysfunction in heart transplant recipients
- Extended the term of the current HIV Organ Policy Equity (HOPE) Act variance
- Endorsed a white paper on ethical considerations of organ allocation policy based on continuous distribution
- Adopted updates to requirements for adult heart transplant candidates needing an extension of exceptional priority
- Approved policy modifications relating to the operation of the National Liver Review Board and updated guidance relating MELD exception priority for certain candidate diagnoses
- Extended the term of a variance addressing liver allocation from blood type O donors in Hawaii and Puerto Rico
- Reaffirmed a requirement for lower respiratory testing of all lung donors for COVID-19
- Approved updates to data collection relating to recent Public Health Service guidance for assessing risk of bloodborne donor-transmitted disease
- Endorsed a guidance document for member organizations to report donor or transplant patient citizenship
- Approved updates to equivalency tables used in histocompatibility matching
- Accepted changes to data collection related to transplant candidates and recipients with alcohol-associated liver diseases
Discussion items
The Board additionally discussed a number of topics, including:
- Work in progress on a pilot project to use predictive analytics to help transplant programs evaluate organ offers
- Policy development and other projects involving kidney and/or pancreas allocation, including ongoing development of policy based on continuous distribution
- A report on measures of quality of OPTN data and recommendations under consideration for further improvement
- A review of monitoring activities of OPTN members for quality management and compliance with OPTN requirements
- An update on the OPTN budget and finances
- Metrics on the performance of the OPTN policy-making process
