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OPTN Board approves updated variance policy

Published on: Wednesday, May 8, 2024

The OPTN Board of Directors, on March 26, 2024, approved updates to OPTN policy regarding variances. The updates include creation of a special variance process for rapid testing and evaluation of “rescue pathway” protocols, which are alternative, expedited methods of organ placement intended to increase usage of deceased donor organs.

The protocols to be studied are intended to get harder-to-place organ offers more quickly and reliably to transplant programs willing to consider such offers for their candidates. All protocols proposed for consideration by the OPTN Executive Committee will be published on the OPTN website, available via the Expeditious Task Force page, and will include an opportunity for public feedback on their use, as well as outcome data when available of the protocols ultimately approved and tested. In addition, while all protocols are intended as short-term trials, the variance contains criteria that may end a protocol early if it results in specific, unanticipated, negative outcomes.

“The early work of the OPTN Expeditious Task Force has shown that there are multiple ways in which new organ placement methods can improve organ usage,” said Dianne LaPointe Rudow, DNP, president of the OPTN board. “To help the community reach the bold aim of 60,000 successful deceased donor transplants by 2026, we intend to study multiple approaches at the same time and in a time frame just long enough to assess their potential for broader usage. These are meant as trial approaches, and we will be sure to balance equity and medical utility throughout the process. The protocols that show the best potential may be further developed into national organ allocation policies through our regular development process.”

Organ procurement organizations and/or transplant programs wishing to recommend protocols for testing may send an e-mail with details to A working group of the Expeditious Task Force will evaluate the recommendations and provide them to the OPTN Executive Committee for final consideration and approval.

Accelerated placement of hard-to-place kidneys

Proposed protocol under review to speed placement of kidneys used less often.

View protocol and provide feedback