Updating the kidney donor risk index: Removing donor race and hepatitis C virus status.

This study reports the results of a recalculation of the kidney donor risk index (KDRI) formula requested by the Organ Procurement and Transplantation Network's Minority Affairs Committee to remove donor race and hepatitis C virus (HCV) status variables. The updated KDRI model was fit on adult, deceased donor, solitary kidney, first-time transplants from 2018 through 2021. Deceased donors from 2018 through 2021 were included in a counterfactual analysis to evaluate how the kidney donor profile index (KDPI) would change if race and HCV seropositivity were excluded.

OPTN/SRTR 2022 Annual Data Report: Deceased Organ Donation.

The Scientific Registry of Transplant Recipients uses data collected by the Organ Procurement and Transplantation Network to calculate metrics such as organs recovered per donor, organs transplanted per donor, and organs recovered for transplant but not transplanted (ie, nonuse). In 2022, there were 14,905 deceased donors, a 7.5% increase from 13,863 in 2021, and this number has been increasing since 2010.

Adjusting for race in metrics of organ procurement organization performance.

The Scientific Registry of Transplant Recipients has previously reported the effects of adjusting for demographic variables, including race, in the Centers for Medicare & Medicaid Services (CMS) organ procurement organization (OPO) performance metrics: donation rate and transplant rate. CMS chose not to adjust for most demographic variables other than age (for the transplant rate), arguing that there is no biological reason that these variables would affect the organ donation/utilization decision. However, organ donation is a process based on altruism and trust, not a simple biological phenomenon.

Impact of Centers for Medicare and Medicaid Services Final Rule on Organ Procurement Organization Metrics and Procedural Trends in the Procurement of Pancreata for Research.

Objective: Pancreata recovered for research are included as a success (or positive) in the Centers for Medicare and Medicaid Services' (CMS) donation and organ transplantation rate metrics for recertification of organ procurement organizations (OPOs).

Materials And Methods: Given these metrics directly incentivize recovery of pancreata for research, this study tracks trends in recovery of pancreata for research across the implementation of the CMS metrics.

Results: In the 26 months before the December 2, 2020, publication of the CMS metrics, research pancreata as a percent of organs transplanted, including research pancreata, was 1.

Use of exception status listing and related outcomes during two heart allocation policy periods.

Background: The October 2018 update to the heart allocation policy was intended to decrease exception status requests, whereby candidates are listed at a specific status due to perceived need despite not meeting prespecified criteria of illness severity. We assessed the use of exception status and waitlist outcomes before and after the 2018 policy.

Methods: We used data from the Scientific Registry of Transplant Recipients on adult heart transplant candidates listed from 2015 to 2021.