From the MPSC: Best practices for utilizing donor screening criteria and other recommendations

Published on: Tuesday, June 24, 2025

In March, the OPTN Membership and Professional Standards Committee (MPSC) convened virtually over several days. These extended sessions foster collaboration among committee members from across the country and provide dedicated time to develop recommendations that uphold the integrity of the national transplant system and promote accountability. Community updates and related materials from the MPSC are available on the OPTN website. In addition, the MPSC acknowledges ongoing efforts related to OPTN critical comments and remains actively engaged in evaluating Allocation Out of Sequence (AOOS) and other directives from HRSA.

As part of the MPSC’s ongoing work reviewing policy compliance, patient safety, allocation practices, membership matters, and program performance, several topics have arisen that the committee wants to highlight for the community. These areas may present opportunities for improvement or warrant continued focus by OPTN members, as we collectively strive to maintain the highest standards of safety and patient care. The MPSC noted the following themes from our discussions:

• Utilizing donor screening criteria to accurately reflect what organ offers you are willing to evaluate
• Responsibility to comprehensively review organ offers and donor attachments
• The role of third-party vendors and contracted services in the OPTN
• Diligence in appropriately importing donor files
• Request for sharing best practices in IT automation

Utilizing donor screening criteria to accurately reflect what organ offers you are willing to evaluate

The MPSC has observed instances where transplant programs enter donor screening criteria that do not reflect the types of donors they are actually willing to evaluate or accept. This includes setting extreme or unfeasible values (e.g., a minimum donor age over 99) to effectively inactivate candidates, an inappropriate practice that can lead to unintended consequences. Donor screening criteria are intended to help programs receive more relevant offers by accurately representing the donors they are willing to consider, thereby supporting thoughtful review and increasing candidates’ chances of transplant. Programs are expected to apply these criteria accurately, consistently, and fairly.

Responsibility to comprehensively review organ offers and donor attachments

The MPSC has observed a rise in incomplete or cursory reviews of organ offers by transplant teams, often indicated by the entry of a “provisional yes” without a thorough assessment. This practice can lead to a range of downstream issues, including reduced allocation efficiency, challenges in reallocation, and potential allocation out of sequence (AOOS) or non-utilization of organs.

OPTN Policy 5.6: Receiving and Accepting Organ Offers outlines the responsibility of transplant programs to assess the medical suitability of organ offers in a timely manner. Once an offer is accepted, the program is obligated to either proceed with transplant or assist in appropriate reallocation.

The MPSC expects transplant programs to conduct prompt and comprehensive reviews of all organ offers and related documentation, ensuring they are fully prepared to accept an organ when their candidate reaches the top of the match run. Active and thoughtful engagement in this process is essential to honoring the gift of donation and supporting equitable and effective organ allocation.

The role of third-party vendors and contracted services in the OPTN

As contracted services and third-party vendors play an increasingly significant role in transplantation, it is essential for the MPSC to gain a broader understanding of the types of quality or safety issues involving these entities. This insight will help inform future policy development. Under current OPTN policy, members are responsible for the actions of any contracted services and third-party vendors who perform donation and transplantation activities that fall within members’ OPTN obligations.

The MPSC reminds the community of their responsibility to report safety events to the OPTN Patient Safety Reporting Portal for compliance and quality review. Additionally, members are responsible for submitting medical device malfunction and associated events directly to the FDA. Using both reporting channels, as appropriate, contributes to overall system improvement, ultimately enhancing our collective ability to safely transplant organs to more people in need.

For additional guidance, please review the OPTN-FDA webinar, which provides a helpful refresher on what can and should be reported.

Diligence in appropriately importing donor data files

The MPSC has identified a concerning trend in which correct donor testing is performed, but incorrect donor files—particularly related to blood type and histocompatibility—are uploaded into the OPTN Computer System. These data points are critical for ensuring safe and successful transplants. While these errors have fortunately been caught before transplant in reported cases, they pose serious risks to patient safety and can significantly impact system efficiency. If undetected, such errors could result in graft failure or even patient death.

OPTN members are strongly encouraged to proactively review their standard operating procedures (SOPs) and verification processes to identify and address any gaps that could lead to incorrect data entry. These reviews should include confirming that primary source documentation is used and ensuring that all relevant staff are trained to recognize and rely on valid source documents

Request for sharing best practices in IT automation

The MPSC has recognized automating data uploads to the OPTN Computer System can reduce errors in essential, patient safety-related data and documentation. Some members have already identified and implemented effective IT solutions that enable seamless, automated data transfer into the OPTN Computer System.

To support broader system improvement, we are interested in gathering and sharing best practices with the transplant community. If you have a best practice in IT automation that you would like to share with the community, we invite you to share your approach.

For questions or comments regarding this communication, please email MQFeedback@unos.org.