OPTN Board approves update to transplant program outcome monitoring criteria; expected to increase organ usage, reduce waitlist deaths

Published on: Monday, December 2, 2024

The Board of Directors of the Organ Procurement and Transplantation Network, meeting on Nov. 21, unanimously approved updated criteria for reviewing post-transplant outcomes in adult transplant recipients. The measure is intended to increase the acceptance and use of available organs by addressing concerns regarding close monitoring of patient survival and organ function after transplant (graft survival).

“A vital emphasis of the OPTN is to increase organ usage,” said Richard Formica, M.D., OPTN board president. “U.S. transplant programs maintain excellent transplant survival overall. But we have often heard from transplant professionals that they may be willing to use more organs if there is a reasonable adjustment in the threshold for additional monitoring. This action will ensure that reviews will still take place for programs with major challenges meeting expectations, while accounting for a reasonable adjustment for greater organ usage that will help more people get timely transplants.”

The OPTN monitors post-transplant outcomes for each transplant program based on graft survival (length of time the transplanted organ functions). If a program’s actual outcomes fall significantly below a statistical expectation for those outcomes, the OPTN will direct a more focused review of the program to help it identify and address potential issues of quality and patient safety.

The action taken by the OPTN board addresses graft survival for adult transplant recipients only. It increases slightly the amount of statistical variation by which a program may be identified for further review. Specifically, it moves the review threshold for short-term outcomes from the current level (actual graft failures at the transplant program at least 75 percent higher than statistically expected) to a threshold of at least 125 percent higher than expected.

The revision is intended to encourage transplant programs to accept and use donor organs that may have a slightly higher risk of short-term failure, but which may result in more transplants with good function. An increase in transplant volume may also reduce deaths among candidates waiting for a transplant.