The OPTN’s processes to monitor organ allocation allows UNOS to ensure that every donor organ is allocated in the proper sequence and according to policy.
We understand that sometimes a transplant center will accept an organ for a potential transplant recipient, but then ultimately transplant that organ into a different recipient. When this occurs, the applications within our UNetSM computer system allow our allocation analysts to easily track what happened. But our analysts can only do this if the original data entry has not been changed.
To illustrate our point, we’ll give you two examples: one that describes what you shouldn’t do in these cases and the other that describes what you should do.
Scenario 1: What we don’t recommend
Your OPO offers Transplant Center Z a kidney for potential recipient #3. Transplant Center Z accepts the offer for recipient #3, but then actually transplants that kidney into recipient # 50 instead. Transplant Center Z calls you to explain why they transplanted the organ into recipient #50 and asks you to change the original match run so that it accurately reflects who received the organ. But if you do this, it would appear that you did not offer the organ to all the potential transplant recipients between #3 and #50. This would look like a potential policy violation to our analysts and would prompt a sometimes lengthy and unnecessary investigation.
Scenario 2: What we recommend
Your OPO offers Transplant Center Z a kidney for potential recipient #3. Transplant Center Z accepts the offer for #3, but then actually transplants that kidney into recipient #50 instead. Transplant Center Z calls you and asks for you to change the original match run so that it accurately reflects who received the organ. You should not change the original match run and should instead instruct Transplant Center Z to contact their local OPO to generate an import match run that shows who actually received the organ. The import match run information is reflected in the TIEDI application.
Final tips:
- DonorNet records will show our analysts who originally accepted the organ (as long as the original match run is not modified).
- Tiedi data will indicate who actually received that organ.
- OPOs should not change the original acceptance codes in DonorNet and Transplant Centers should not ask them to. This will make it much easier for our allocation analysts to track what happened and may reduce how often they need to follow up with centers and OPOs on a particular case.
- When an organ is allocated to a local back up, that recipient will be indicated on the import match run.
Following these advised practices will make it easier for everyone—OPOs, transplant centers, and UNOS staff who are investigating allocations that are flagged. Thank you for your attention.
