Policy Notices

Policy process

Item	Action	Target implementation date
Update to Refusal Codes	06/2021 Board action	12/2/2021
Clarify Multi-Organ Allocation Policy	06/2021 Board action	12/2021
Modify Data Submission Policies	12/2019 Board action	03/2022
Further Enhancements to the National Liver Review Board Policy 9.5.I.i: Initial Assessment and Requirements for HCC Exception Requests	12/20 Board action	5/2022, contingent upon OMB approval
Changes to Islet Bylaws	12/2018 Board action	06/2022
OPTN Data Collection Changes: Update to VCA Transplant Outcomes Data Collection	12/2020 Board action	06/2022
Programming VCA Allocation in UNet	12/2020 Board action	06/2022, contingent upon OMB approval
Modify Data Collection on Living VCA Donors (pending OMB approval)	12/2020 Board action	06/2022, contingent upon OMB approval
Calculate Median MELD at Transplant around the Donor Hospital and Update Sorting within Liver Allocation	06/2021 Board action	06/2022
Modifications to the Deceased Donor Registration (DDR)	06/2021 Board action	06/2022

Item	Action	Effective date
Implemented policy items in 2021
Further Enhancements to the NLRB Policy 9.5.G: Requirements for Portopulmonary Hypertension MELD or PELD Score Exceptions National Liver Review Board Operational Guidelines Guidance to Liver Transplant Programs and the National Liver Review Board for Adult MELD Exception Review	12/2020 Board action	10/07/2021
Updating National Liver Review Board Guidance and Policy Clarification Policy 9.5.A: Requirements for Cholangiocarcinoma (CCA) MELD or PELD Score Exceptions	06/2021 Board action	10/07/2021
Refine Lung Data Fields	07/2021 Executive Committee Action	09/30/2021
Updated Cohort for Calculation of the LAS	12/2020 Board action	09/30/2021
Require Notification of Critical Human Leukocyte Antigen (HLA) Typing Changes	06/2021 Board action	09/01/2021
Modify Living Donor Policy to Include Living VCA Donors	06/2021 Board action	09/01/2021
Updating National Liver Review Board Guidance and Policy Clarification Guidance to Liver Transplant Programs and the National Liver Review Board for Pediatric MELD or PELD Exception Review Guidance to Liver Transplant Programs and the National Liver Review Board for Adult MELD Exception Review	06/2021 Board action	07/15/2021
Human Leukocyte Antigen (HLA) Equivalency Tables Update 2020	06/2020 Board action	06/17/2021
National Heart Review Board for Pediatrics	06/2020 Board action	06/15/2021
Clarification of Policies and Bylaws Specific to Vascularized Composite Allografts	06/2021 Board action	06/14/2021
Combined Policy Notice for VCA Membership Requirements (2020) VCA - List Covered Body Parts - 1 of 2 Policy 1.2: Definitions Bylaws Appendix D: Membership Requirements for Transplant Hospitals and Transplant Programs; Appendix J: Membership Requirements for Vascularized Composite Allograft (VCA) Transplant Programs; and Appendix M: Definitions Align VCA program membership requirements with other programs Membership Requirements for VCA Transplant Programs	06/2015, 06/2016, 06/2018 Board action	06/14/2021
Align OPTN Policy with US PHS Guideline 2020 Policy 14.3: Informed Consent Requirements Policy 14.8.B: Living Donor Specimen Collection and Storage	12/2020 Board action	06/01/2021
Lower Respiratory SARS-CoV-2 Testing for Lung Donors	04/26/21 Executive Committee action	05/27/2021
Expedited Liver Placement	12/2019 Board action	03/25/2021
Pancreas Removal of DSA	12/2019 Board action	03/15/2021
Kidney Removal of DSA	12/2019 Board action	03/15/2021
Addressing Medically Urgent Candidates in New Kidney Allocation Policy	06/2020 Board action	03/15/2021
Distribution of Kidneys and Pancreata from Alaska	06/2020 Board action	03/15/2021
Modifications to Released Kidney and Pancreas Allocation	06/2020 Board action	03/15/2021
Guidance and Policy Addressing Adult Heart Allocation Policy 6.1.A.ii: Non-dischargeable, surgically implanted, non-endovascular biventricular support device: Effective March 4, 2021 Policy 6.1.C.vi: Mechanical Circulatory Support Devise (MCSD) with Device Infection: Effective March 4, 2021 Policy 6.1.D.ii: Inotropes without Hemodynamic Monitoring: Effective March 4, 2021 Guidance for Adult Heart Exceptions for Status 2 Candidates Experiencing Cardiogenic Shock: Effective February 9, 2021	12/2020 Board action	02/09/2021, 03/04/2021
Align OPTN Policy with US PHS Guideline 2020 Split implementation. Additional actions targeted for June 2021 implementation. 1.2: Definitions 2.2: OPO Responsibilities 2.4: Deceased Donor Medical and Behavioral History 2.5: Hemodilution Assessment 2.7.A: Exceptions to HIV Screening Requirement 2.9: Required Deceased Donor Infectious Disease Testing 13.11: Receiving and Accepting KPD Match Offers 14.1.A: Living Donor Psychosocial Evaluation Requirements 14.4.A: Living Donor Medical Evaluation Requirements 14.9.B: Psychosocial and Medical Evaluation Requirements for Domino and Non-Domino Therapeutic Donors 15.2: Potential Candidate Screening Requirements 15.3.B: Donors with Risk Identified Pre-Transplant 15.3.C: Recipients of Organs from Donors with Increased Risk of Disease Transmission 16.3.D: internal labeling of Extra Vessels	12/2020 Board action	03/2021
Guidance Addressing the Use of Pediatric Heart Exceptions	12/2020 Board action	02/09/2021
Further Enhancements to the National Liver Review Board Split implementation. Additional actions targeted for June 2021 implementation. Guidance to Liver Transplant Programs and the National Liver Review Board for Adult MELD Exception Review	12/2020 Board action	02/09/2021
Implemented policy items in 2020
Establish Pediatric Training and Experience	12/2015 Board actions	12/07/2020
Revise Pediatric Emergency Membership Exception Pathway	12/2017 Board action	12/07/2020
Incorporating COVID-19 Related Organ Failure In Candidate Listings	10/2020 Board action	10/28/2020
Enhancements to the National Liver Review Board Policies 9.4.A: MELD or PELD Score Exception Requests and 9.4.D: Calculation of Median MELD or PELD at Transplant: Effective August 4, 2020 Operational Guidelines: Effective August 4, 2020 Operational Guidance: Effective August 4, 2020 Policies 9.4.C: MELD or PELD Score Exception Extensions and 9.5.I.vii: Extensions of HCC Exceptions: Effective September 10, 2020	06/2020 Board action	08/04/2020, 09/10/2020
Guidance and Policy Modifications Addressing Blood Type Determination Guidance: Effective June 8, 2020 Policy: Effective September 1, 2020	06/2020 Board action	06/08/2020,09/01/2020
Modify the Conflicts of Interests Bylaws	06/2020 Board action	07/01/2020
Creation of OPTN Heart and Lung Committees	03/2020 Board action	07/01/2020
Modify Lung TRF to Improve Post Transplant Lung Function Data	06/2018 Board action	06/30/2020
Eliminate the Use of Regions in VCA Distribution	06/2019 Board action	06/18/2020
Modify HOPE Act Variance to Include Other Organs	06/2019 Board action	05/21/2020
COVID-19 Emergency Policy Package	04/2020 Executive Committee action	04/03/2020
Clarifications on Reporting Maintenance Dialysis	06/2019 Board action	04/01/2020
Updates to Candidate Data During 2020 COVID-19 Emergency	03/2020 Executive Committee action	03/17/2020
Variances Removal Policy Notice	12/2019 Board action	03/01/2020
Clarification of Pre-Existing Liver Disease	12/2019 Board action	03/01/2020
Addressing HLA Typing Errors	12/2018 Board action	02/27/2020
Access for Urgent Liver Candidates in Hawaii & Puerto Rico	01/2020 Executive Committee action	02/18/2020
Liver and Intestine Distribution Using Distance from Donor Hospital	12/2018 Board action	02/04/2020
Reduce Reporting Burdens and Clarify Policies on Extra Vessels Table 16.1: Required information on internal labels for extra vessels, number 7 (donor infectious disease results)	06/2018 Board action	01/29/2020
Update Transplant Hospital Definition	12/2016 Board action	01/13/2020
Eliminate the Use of DSAs in Thoracic Organ Distribution	06/2019 Board action	01/09/2020
Implemented policy items in 2019
Adding DR Antigens and Equivalences	12/2019 Board Action	12/04/2019
Hope Act Policy and Mini Brief	12/2019 Board action	12/03/2019
Modify Appointment Process for the Histocompatibility Vice Chair	12/2019 Board Action	12/03/2019
Aligning Units of Distribution in Closed Variance for Split Liver Transplantation	12/2019 Board Action	12/03/2019
Split Liver Variance	06/2019 Board action	12/03/2019
Revising Priority Points in Kidney Paired Donation Program	12/2015 Board action; 10/2019 Executive Committee action	10/24/2019
Improving Dual Kidney Allocation	12/2017 Board action	9/2019
Improving en Bloc Kidney Allocation	12/2017 Board action	9/2019
Changes to Waiting Time Criteria for Kidney-Pancreas Candidates	06/2018 Board action	7/11/2019
Guidance on Effective Practices in Organ Distribution	06/2019 Board action	6/10/2019
Ethical Implications of Multi-Organ Transplants White Paper	06/2019 Board action	6/10/2019
Revised National Liver Review Board Policies	12/2018 Board action	5/14/2019
National Liver Review Board	06/2017 Board action	5/14/2019
Histocompatibility Bylaws Rewrite: General Supervisor	06/2015 Board action	3/1/2018
Pancreas Program Functional Inactivity	12/2018 Board action	4/8/2019
Addressing HLA Typing Errors Policy 2.2 (OPO responsibilities) Bylaws C.2.D (OPO affiliation)	12/2018 Board action	3/1/2019
Amend CPRA Calculator	01/2019 Executive Committee action	1/17/2019
Implemented policy items in 2018
Change to Hospital-Based OPO Voting Privileges	12/2018 Board action	12/4/2018
Frameworks for Organ Distribution	12/2018 Board action	12/4/2018
Pediatric Transition and Transfer Guidance	12/2018 Board action	12/3/2018
Intestine Membership Bylaws Requirements	06/2015 Board action	11/20/2018
Modify Adult Heart Allocation	12/2016 Board action	10/18/2018
Clarification of Adult Heart Allocation	08/2017 Executive Committee action	10/18/2018
Review Board Guidance on HCM and RCM Exceptions	06/2018 Board action	10/18/2018
Modifications to the Distribution of Deceased Donor Lungs	06/2018 Board action	10/18/2018 (Policy 6.6.F) 06/12/2018 (Policies 1.2, 10.2.A, 10.4)
Clarify Informed Consent Policies for Transmittable Diseases	06/2018 Board action	09/01/2018
Reduce Reporting Burdens and Clarify Policies on Extra Vessels	06/2018 Board action	09/01/2018 (except table 16.1)
VCA - List Covered Body Parts (2 0f 2) Bylaws Appendix J: Membership Requirements for Vascularized Composite Allograft (VCA) Transplant Programs: Effective September 1, 2018 Policy 1.2: Definitions: Target implementation date: December 2021 Bylaws Appendix D: Membership Requirements for Transplant Hospitals and Transplant Programs; Appendix J: Membership Requirements for Vascularized Composite Allograft (VCA) Transplant Programs; and Appendix M: Definitions: Target implementation date: December 2021	06/2016 Board action	09/01/2018
Improving the Efficiency of Organ Allocation	12/2017 Board action	03/01/2018 (Policies 2.2, 2.11 and 2.12) 05/02/2018 (Policies 1.2 and 5.6.B) 06/12/2018 (Policies 2.11.A and 2.11.D) 06/13/2018 (Policy 5.6.C)
Revising OPTN Bylaws Appendix L	06/2018 Board action	06/12/2018
Retrospective Review of Clerical Policy Changes	06/2018 Executive Committee action	06/12/2018
Approved Transplant Fellowship Training Programs Bylaws	12/2017 Board action	03/01/2018
Definition of Pancreas Graft Failure	06/2015 Board action	2/28/2018
Modification to HCC Extension Criteria		2/5/2018
Implemented policy items in 2017
HCC Auto Approval Criteria Changes	12/2016 Board action 12/2017 Executive Committee action	12/12/2017
Lung Allocation Policy Modification	11/2017 Executive Committee action	11/24/2017
Standardize Organ Coding and Tracking System	2/2017 Executive Committee action	11/01/2017
Improve the Categorization of Living Donor Events	9/2017 executive committee action	10/18/2017
Add DQA-1 Equivalences Table	6/2016 Board action 6/2017 Executive Committee action	09/12/2017
Update HLA Equivalency Tables	12/2015 Board action 4/2017 Executive Committee action	09/12/2017
Personnel Procurement Requirements	12/2015 Board action	09/01/2017
Foreign Equivalent in Bylaws	12/2015 Board action	09/01/2017
Bylaws Rewrite	06/2017 Board action	09/01/2017
Primary Kidney Transplant Physician Update	12/2016 Board action	09/01/2017
Clarification to Apply Kidney Minimum Acceptance Criteria to Highly Sensitized Candidates	07/2017 Executive Committee action	09/01/2017
Simultaneous Liver-Kidney Allocation	06/2016 Board action	08/10/2017
Kidney: KAS Clarifications (part)	06/2016 Board action	06/29/2017
Retrospective Review of Clerical Changes to Policies	06/2017 Executive committee action	06/29/2017
Informed Consent Changes - Potential Living Donors	12/2016 Board action	06/01/2017
Improving Post-Transplant Communication (part)	06/2016 Board action; Required toxoplasmosis testing of all donors	04/06/2017
Pediatric Lung Allocation Changes	12/2015 Board action	03/30/2017
All Other KPD Guidelines to Policy (part)	06/2015 Board action	03/30/2017
Post-Implementation ABO Policy Changes	12/2016 Board action	03/01/2017
Primary Transplant Surgeon Changes	12/2016 Board action	03/01/2017
Primary Transplant Physician Subspecialty Changes	12/2016 Board action	03/01/2017
Remove Donor Location from Required Procurement Log	12/2016 Board action	03/01/2017
Changes to Imminent and Eligible Definitions	12/2016 Board action	01/01/2017
Implemented policy items in 2016
Retrospective Review of Clerical Changes to Policies	12/2016 Executive committee action	11/10/2016
Registration Fee	06/2016 Board action	10/01/2016
DTAC Policy Clarification	06/2016 Executive Committee action	09/01/2016
OSC Policy Clarification	08/2016 Executive Committee action	09/01/2016
HOPE Act	06/2016 Board action	09/01/2016
Improving Post-Transplant Communication (part)	06/2016 Board action	09/01/2016
Kidney: KAS Clarifications (part)	06/2016 Board action	09/01/2016
Regional Councillor Vacancy	06/2016 Board action	09/01/2017
Living Donor Candidate Registration	04/2016 Executive Committee action	04/14/2016
Retrospective Review of Clerical Changes to Policies	12/2016 Executive committee action	4/14/2016
Implemented policy items in 2015
KPD Informed Consent	06/2015 Board action	12/01/2015

Item	Action	Effective Date
COVID-19 policy items in 2021
Repeal Policy 3.7.D: Applications for Modifications of Kidney Waiting Time during 2020 COVID-19 Emergency	06/2021 Executive Committee Action	09/01/2021
Repeal Policy 1.4.F: Updates to Candidate Data during 2020 COVID-19 Emergency	04/2021 Executive Committee Action	07/27/2021
Lower Respiratory SARS-CoV-2 Testing for Lung Donors	04/2021 Executive Committee Action	05/27/2021
Conclude Relaxation of Data Submission Requirements for Follow Up Forms	03/2021 Executive Committee Action	04/01/2021
COVID-19 Emergency Policy Package (Board Action)	12/2020 Board Action	Various
COVID-19 Emergency Policy Package (Executive Action)	04/2020 Executive Committee Action	Various
Updates to Candidate Data during 2020 COVID-19 Emergency	03/2020 Executive Committee Action	03/17/2020

Organ Procurement and Transplantation Network

Policy Notices