Executive Order on Advancing American Kidney Health

UNOS’ role in increasing transplantation

About the Executive Order

Signed in July 2019, the Executive Order on Advancing American Kidney Health launched a number of efforts with the collective goal of improving medical care and quality of life for people with end-stage kidney failure. These efforts include a series of federal regulations proposed by the Department of Health and Human Services.

UNOS welcomes the attention and effort being devoted to improving the life and health of people with kidney disease. Of particular interest to the organ donation and transplantation community are efforts to improve performance metrics for organ recovery and to promote innovation in the national information technology system used to match organ donors and recipients.

Supporting continuous improvement

As a community we are committed to improving the services we provide. We believe that improvement is best driven by medical evidence and a thorough understanding of the real-life practice of donation and transplantation. OPOs and transplant hospitals are inextricably linked and reliant on each other; neither can increase transplants alone. They must work collaboratively and be mutually accountable for increasing transplants.

UNOS, as the national Organ Procurement and Transplantation Network (OPTN), recently convened an ad hoc committee that identified a number of potential metrics and approaches to improve transplant system effectiveness—combining the efforts of OPOs and transplant hospitals. Key themes in the committee’s findings include the need for greater communication, transparency and accountability to foster improved transplant community performance. The committee agreed these themes are integral to success for the transplant system as a whole, and may serve as a foundation for future work by the OPTN, other key stakeholders, regulatory bodies or the private sector.

Driving change

To continue to increase the number of transplants nationwide, UNOS facilitates innovation and continuous improvement projects with the organ donation and transplant community.

For example, the Executive Order highlighted one particular UNOS program, the Kidney Accelerated Placement project, which speeds the placement of extremely hard-to-place kidneys via the UNOS Organ Center. Other projects currently underway to increase organ utilization include:

• Developing offer filters in the organ matching process to give transplant programs more individual flexibility in listing the specific sorts of organ offers they are or aren’t willing to accept for their candidates
• Reducing the amount of time transplant programs have to respond to an organ offer, allowing offers to go to a larger number of programs if they’re not accepted within the first few attempts
• Upgrading the organ matching system to include sharing of diagnostic images of donor organs
• Facilitating peer-to-peer sharing of transplant hospital practices that have proven to be effective in accepting and using hard-to-place donor kidneys
• Creating and sharing new data analytic tools with donation and transplantation professionals to identify opportunities for improvement in donor selection and organ offer acceptance