Input sought on proposed protocol to increase kidney usage; virtual town hall May 20

Published on: Tuesday, May 14, 2024

The OPTN is reviewing the first proposed protocol among a planned series of intended approaches to increase organ usage through more efficient placement. Additional protocols will be developed for trial and assessment using updates to the OPTN variance process recently approved by the OPTN Board of Directors. Any interested person or organization may review the details of the protocol and offer input, which will be posted on the OPTN website and considered along with evaluation of the protocol’s results.

As part of the process of seeking input, a virtual town hall was held on May 20. A recording is available above. You may also provide input about the proposed protocol on its summary page on the OPTN website, and feedback will be publicly displayed on the page.

The revised variance process supports the work of the OPTN Expeditious Task Force, which is applying and assessing ways to increase usage of donated organs. Multiple protocols can be developed and tested simultaneously in short-term, time-limited trials. Any approaches that show positive results and could be used in OPTN policy will be referred to the appropriate OPTN committee(s) for consideration through the policy development process.

The proposed protocol applies to offers of deceased donor kidneys with a Kidney Donor Profile Index (KDPI) of 75 percent or higher. The KDPI value reflects the likely length of kidney function (graft survival) as compared to all deceased kidney donors; a higher value indicates the kidney will be less likely to function as long as a kidney from a lower-KDPI donor. (See a video that explains the KDPI score and how it is used in kidney allocation.)

Research shows that kidneys from donors with a KDPI of 70 percent or greater are accepted and used for transplant much less frequently than kidneys with a lower KDPI value, with the non-use rates increasing as the KDPI percentage increases. The goal of the trial protocol is to determine whether more kidneys from high-KDPI donors can be used successfully by identifying appropriate candidates and prioritizing them at an early stage of the placement process.

The protocol under consideration would seek voluntary participation from up to five organ procurement organizations (OPOs) and from kidney transplant programs with a demonstrated history of accepting and using kidneys from donors with a KDPI of 75 percent or higher.

During the trial period, when a participating OPO recovers kidneys from donors in this KDPI range, it would first make organ offers to those kidneys to high priority candidate classifications in OPTN policy. After that, but before other candidates in the policy sequence, the OPO would make offers to candidates the participating kidney programs have pre-identified as being willing and eligible to receive such offers.