2021 Organ Procurement and Transplantation Network policy increases transplant rate

The Organ Procurement and Transplantation Network identified a 5.1% increase in transplants per 100 active patient years following its 2021 policy change, according to a presentation at the American Transplant Congress.

“On March 15, 2021, the Organ Procurement and Transplantation Network (OPTN) implemented a new policy removing donation service areas (DSA) and OPTN regions as geographical units of allocation from deceased donor kidney policy and replaced those with 250-nautical mile circles around the donor hospitals,” Amanda Robinson, MS, research scientist at United Network for Organ Sharing, said in the presentation. She added, “Since one of the primary goals of this policy change was to increase equity and access to transplant, we decided to look at transplants per 100 active patient years for particular subgroups of interest.”

Researchers examined all deceased donor kidney transplants and registrations waiting at any time between October 2020 and August 2021 from the OPTN database. Participants were categorized into cohorts as 1 year before the policy change and 1 year after the policy change. Using univariate Poisson tests, researchers evaluated statistical significance between transplant rates.

Researchers identified an increase in overall transplant rate from 32.6 to 37.7 transplants per 100 active patient years after the policy was implemented. The increase was seen across several subpopulations, including pediatric patients, Black patients, Hispanic patients, patients with calculated panel reactive antibody level at listing and patients with more than 3 years of dialysis time at listing.

Robinson concluded, “The OPTN kidney committee will continue to monitor the impact of this policy change, and we anticipate having a comprehensive 1-year monitoring report available on the OPTN website by the end of the month.”

Editor's Note: This story was updated on June 10, 2022, to clarify the meaning of DSA and to remove a word. The Editors regret the error.