Continuous Distribution of Kidneys & Pancreata Request for Feedback

At a glance

Background

In December 2018, the OPTN Board of Directors approved the continuous distribution framework for allocation of all organs. Continuous distribution will rank waiting list candidates based on points related to various factors, such as medical urgency, post-transplant survival, candidate biology, patient access, and placement efficiency. Continuous distribution will remove the hard boundaries built into the current framework to increase equity for patients and transparency in the system.

This request for feedback builds upon the 2021 concept paper, provides an overview of the project’s development process and progress, and offers next steps for continuous distribution of kidneys and pancreata. The paper also requests community feedback that will assist the Kidney and Pancreas Committees’ work.

Supporting media

Watch Rachel Forbes, M.D., chair of the Pancreas Transplantation Committee, provide an overview of the request for feedback on continuous distribution of kidneys and pancreata.

Watch a recording of a Feb. 18 webinar for patients: "Moving toward kidney and pancreas continuous distribution allocation." Panelists include members of the Patient Affairs Committee, the Pancreas Transplantation Committee, and the Kidney Transplantation Committee.

Overview presentation

View presentation

Requested feedback

• The community is asked to participate in a prioritization exercise, named Analytical Hierarchy Process (AHP), that will help the committees determine how to rank the various attributes.
• What other factors should be incorporated into the allocation of kidneys and pancreata within a continuous distribution framework?
• Key questions surrounding each attribute including their rating scale shapes, weights, and how they should work in the new system.

Anticipated impact

• What it's expected to do
  • Provide a more equitable approach to matching candidates and donors.
  • Remove hard boundaries that prevent candidates from being prioritized higher on the match run
  • Establish a system that is flexible enough to work for each organ type
• What it won't do
  • This request for feedback is not a proposed policy change, but will help the Kidney and Pancreas Committees develop a future policy proposal

Terms to know

• Attribute: Attributes are criteria we use to classify then sort and prioritize candidates. For example, in kidney allocation, criteria include medical urgency, blood type compatibility, HLA matching, and others.
• Composite Allocation Score: A composite allocation score combines points from multiple attributes together. This request for feedback proposes the use of composite allocation scores in a points-based framework.
• Rating Scale: A rating scale describes how much preference is given to candidates within each attribute.
• Weights: Weights reflect the relative importance or priority of each attribute toward our overall goal of organ allocation. Combined with the ratings scale and each candidate’s information, this results in an overall composite score for prioritizing candidates.

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