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Continuous Distribution of Pancreata, Winter 2025

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Background

This paper builds upon the Pancreas Transplantation Committee’s previous request for feedback to update the community on the Committee’s progress to date regarding Continuous Distribution. It also includes the Committee’s discussions and decisions on establishing a pancreas medical urgency option. And includes an update on Scientific Registry of Transplant Recipients’ (SRTR) modeling considerations.

Supporting Media

Presentation

View presentation PDF link

Project update

  • The Committee has continued discussions and made decisions on the pancreas medical urgency exception pathway
  • The Committee has continued discussions and evaluation of pancreas utilization and facilitated pancreas policy
  • SRTR presented its findings to the Committee on the feasibility of including utilization and non-use models in pancreas allocation
  • The Committee appreciates the community’s input regarding logistics efficiencies with pancreas procurement
  • The Committee is working to develop a guidance document on pancreas procurement

Project goals

  • Provides a more equitable approach to matching kidneys and pancreas candidates and donors
  • Removes hard boundaries between classifications that prevent kidney and pancreas candidates from being prioritized further on the match run
  • Considers multiple patient attributes simultaneously through a composite allocation score instead of within categories
  • Establishes a system that is flexible enough to work for each organ type
  • Creates a uniform system that will make future policy changes faster
  • Considers how Continuous Distribution could impact the goals of decreasing non-use and non-utilization of pancreata

Anticipated impact

  • What it's expected to do
    • Prioritize candidates in a more flexible manner
    • Allow the transplant community to see how much weight is placed on each attribute
    • Improve equity in access to organ transplantation
    • Gather feedback from the community to help inform a potential guidance document
  • What it won't do
    • This update is not a proposed policy change at this time

Terms to know

  • Attribute: Criteria used 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: Combines points from multiple attributes together. This concept paper proposes the use of composite allocation scores in a points-based framework.
  • Match Run: The list of potential recipients printed by the OPO or Organ Center for each organ recovered for the purpose of transplantation from each donor.
  • Modeling: Calculations the Scientific Registry of Transplant Recipients (SRTR) uses to create model predictions on the different attributes and their effect on organ allocation.
  • Rating Scale: Describes how much preference is given to candidates within each attribute.
  • 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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Read the full proposal (PDF)

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