The Health Resources and Services Administration (HRSA) Division of Transplantation (DoT) is monitoring the impact of the coronavirus (COVID-19) public health emergency on organ procurement and transplantation.
Common questions and answers on organ donation and transplantation are here.
The OPTN Organ Center continues its usual functions and can assist transplant hospitals and organ procurement organizations as needed with organ placement or management of key donor or candidate data, in order to provide continuity of essential services.
If you are a transplant candidate and you have been told your transplant program is temporarily changing its usual arrangements, your program is your best contact for information regarding their facility status, appointment scheduling, and availability of critical services. If you need information or assistance in the event of a long-term disruption, contact the toll-free OPTN Patient Services line, (888) 894-6361.
The OPTN Executive Committee, on behalf of the OPTN Board of Directors, has taken a number of actions to help members document COVID-19 issues affecting organ donation and transplantation and to help members focus needed resources in the short term on essential clinical services.
COVID-focused interactive collaborative project
The OPTN has launched an interactive forum for OPTN members to engage on topics specific to donation and transplant during COVID-19. The OPTN COVID Collaborative operates on a secure online communication platform and allows donation and transplant professionals to collaboratively discuss, organize, catalog and archive the learnings and insights developed during the 2020 pandemic.
The site will:
- Offer discussion forums, facilitated by collaborative improvement specialists
- House and organize the member-driven information that results from this collaboration
- Be available for the duration of COVID-19, or until the decision is made to close the project
- Deploy national and regional webinars to support the sharing of effective practices that emerge from site discussions
Participation in the COVID Collaborative is limited to individuals from OPTN member organizations. Registration is required. OPTN members may register here. Participants will receive an email with account and login info. The scope of discussions will include OPTN member business and administrative processes related to the management of COVID crisis, and discussions will be moderated.
For more information about the OPTN COVID Collaborative, email email@example.com.
Temporary changes to data requirements
Several time-limited changes to data reporting requirements have been implemented to reduce administrative burden on members while maintaining collection of information critical to the donation and transplant process.
- For maintaining data to support a transplant candidate’s listing status or waiting time, transplant programs must continue to use the most updated clinical data available and make all reasonable efforts to meet OPTN requirements. If a program is unable to collect updated data due to issues related to COVID-19, or if in its medical judgment the program opts not to collect updated data because of COVID-19 considerations, it may report the most recent clinical data values it has previously submitted.
- The required submissions of living donor follow-up (LDF), organ-specific transplant recipient follow-up (TRF), and recipient malignancy (PTM) forms due during this time have been suspended. This provision will be backdated to apply to all forms due beginning March 13, 2020, the date of the Presidential declaration of an emergency. It will expire September 30, 2020, although the OPTN Executive Committee will review and may extend the time frame if needed. Recipient death and graft failure will still need to be reported in accordance with policy, though the deadlines were extended from 14 to 30 days. Living donor deaths will still need to be reported in the Protecting Patient Safety Portal in UNetSM.
- If a kidney transplant program evaluates and intends to register a transplant candidate who has not initiated dialysis, but the program is temporarily unable to complete their registration due to COVID-19 considerations, they will be able to modify their candidate’s wait time initiation date later. Further information and instructions on submitting applications will be promulgated soon. The provision will expire on September 30, 2020, although the OPTN Executive Committee will review and may extend the time frame if needed.
COVID-19 code for temporary candidate inactivation
A new candidate temporarily inactive reason code, “COVID-19 precaution,” has been added to WaitlistSM to address instances where a transplant program opts to temporarily defer organ offers for a transplant candidate due to issues relating to the COVID-19 outbreak. Doing so does not mean that the candidate is being removed from the transplant waiting list. It means that offers must be temporarily deferred for that patient because of program- or patient-related circumstances.
This code will be used to assess the specific effect of the virus as compared to other reasons a candidate may be inactivated. The transplant program may reactivate the candidate at any time it is again ready to consider the individual to receive organ offers.
New option to report cause of death for transplant candidates
A new cause of death code, “Infection: Viral – COVID-19,” has been added to WaitlistSM and TIEDI® to allow transplant program staff to more accurately report data. This new code will allow for better assessment of the impacts of the COVID-19 pandemic on transplant candidates and recipients.
COVID-specific organ offer refusal codes for transplant programs
Due to the COVID-19 pandemic, some transplant programs may want to refuse certain organ offers for reasons related to the candidate, the donor, or OPO or transplant hospital operational issues. For this purpose, beginning March 25, three new refusal codes may be used for COVID-19-related reasons:
- Refusal code 840: COVID-19 candidate-related reason
- Refusal code 841: COVID-19 donor-related reason
- Refusal code 842: COVID-19 OPO or transplant hospital operational issue
Future evaluation of the impact of this emergency to both the national transplant system and individual transplant programs and OPOs will rely on complete and accurate recording of organ offers refusals related to the pandemic (testing limitations, candidate risk, etc.).
COVID-19 infectious disease testing in DonorNet®
Data fields have been added to DonorNet® to indicate whether COVID-19 testing has been performed on deceased donors, with related information including test methodology and results. These fields are currently optional, to allow visibility of all available test results while not interrupting the organ offer process.
Reporting potential patient safety events
COVID-19 has been added to the list of pathogens of special interest, which should be reported to the OPTN Improving Patient Safety Portal if there is a suspected instance of disease transmission from donor to recipient.
Time-limited changes to member monitoring
The OPTN Membership and Professional Standards Committee has evaluated specific areas of monitoring that are raising particular concern within the community. In an effort to encourage members to use their clinical judgement about what is in the best interests of their patients without the added concern of strict compliance with OPTN Obligations, the MPSC will implement several time-limited emergency changes to member monitoring. These are listed in a supplement to the OPTN Member Evaluation plan, available on the OPTN Compliance page. This document serves as a quick-reference guide to all members’ monitoring changes implemented as a result of the pandemic. It will be regularly updated with any additional monitoring changes implemented during this event.
SRTR data review period extended to May 31
The Scientific Registry of Transplant Recipients has extended the Data Review Period deadline from April 30 to May 31. This allows transplant programs and OPOs more time to review their data for accuracy during this difficult time. Given the rapidly evolving situation, the deadline may be extended again in the future, and SRTR will work closely with HRSA and OPTN leadership to make that determination.
Data Integrity Reports and program-specific report drafts for transplant programs and Donor Level Data sheets and OPO-specific report drafts for OPOs are available to review from April 1 to May 31, until 11:59 PM EDT. Verify data and make changes in UNetSM or DonorNet®. The OPTN, the SRTR and HRSA are discussing modifications to the performance metrics contained in the program-specific and OPO-specific reports and will share more information as it becomes available.
Learn more about the care of transplant candidates and recipients, as well as the screening of potential organ donors at risk of COVID-19, from the following organizations:
- Centers for Disease Control and Prevention COVID-19
- OPTN Patient Services Line
- United Network for Organ Sharing
- National Marrow Donor Program Be the Match
- American Journal of Transplantation
- American Society of Transplantation
- American Society of Transplant Surgeons
- Association of Organ Procurement Organizations
- The Transplantation Society
- View HRSA's COVID-19 Resource Page for more FAQs