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Distribution of Kidneys and Pancreata from Alaska

Proposal Overview

Status: Public Comment

Sponsoring Committee: Kidney Transplantation and Pancreas Transplantation

Strategic Goal: Promote the efficient management of the OPTN

Read the proposal (PDF; 01/2020)

Contact: Tina Rhoades

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eye iconAt a glance

What is current policy and why change it?

Deceased donor kidneys and pancreata from donors in Alaska are first offered to candidates in a designated Donation Service Area (DSA), which helps prevent the organ traveling further to go to a patient in similar need. A new policy will replace DSA with a 250 nautical mile circle around the donor hospital. When this changes, because there are no transplant hospitals in Alaska, there will not be any transplant hospitals located within 250 nautical miles of donor hospitals in Alaska. Without a policy change, all organs procured in Alaska would be offered nationally, which could create inefficiencies in organ placement. This means that these organs could be offered to a patient in Florida before a very similar patient in California if not addressed by a modification of policy.

What’s the proposal?

  • The Seattle-Tacoma International Airport (Sea-Tac) would be a substitute for the donor hospitals in Alaska as the center of the 250 nautical mile circle.

What’s the anticipated impact of this change?

  • What it’s expected to do
    • Promote the efficient placement of kidneys and pancreata from donors in Alaska.
  • What it won’t do
    • Affect the placement of organs donated anywhere other than Alaska.

Themes to consider

  • How this would impact efficient placement of organs.

Terms you need to know

  • Donation Service Area: The geographic area designated by the Centers for Medicare and Medicaid Services (CMS) that is served by one organ procurement organization (OPO), one or more transplant hospitals, and one or more donor hospitals.
  • Donor hospital: The hospital where the deceased or living donor is admitted.
  • Nautical mile: Equal to 1.15 miles and is directly related to latitude and longitude; used in aviation.
  • Click here to search the OPTN glossary.


OPTN Region 6 | 02/18/2020

Strongly support (8), Support (8), Neutral/Abstain (0), Oppose (0), Strongly Oppose (0) The region strongly supported the proposal. There was a comment that this policy aligns with the liver policy, which is a good thing. There were over 40 donors from Alaska in 2019, which was more than some OPOs, so this is not an insignificant number. This is a good policy for the region and for the potential candidates in the community at-large.

OPTN Region 8 | 02/18/2020

Kidney Transplantation and Pancreas Transplantation Committees: Distribution of Kidneys and Pancreata from Alaska No feedback Vote: 8 Strongly Support, 12 Support, 3 Neutral/Abstain, 0 Oppose, 0 Strongly Oppose

LifeCenter Northwest | 02/18/2020

We support this proposal from the OPTN Kidney Transplantation Committee and OPTN Pancreas Transplantation Committees to use the Seattle-Tacoma International Airport (Sea-Tac) as a virtual location for donor hospitals in Alaska as the center of the 250 nautical mile circle for purposes of allocation of deceased donor kidneys and pancreata from donors in Alaska. This is consistent with the following provision in the Acuity Circle Liver and Intestine allocation policy: 9.10.C Location of Donor Hospitals - For the purposes of determining the location of the donor hospital, livers, intestine, and liver-intestine organs procured in Alaska will be considered procured from the Seattle Tacoma Airport, Seattle Washington. As described in this proposal, it will promote the efficient placement of kidneys and pancreata from donors in Alaska, since there are no transplant programs in Alaska. Without this modification, all kidney and pancreas offers from Alaska donors would first be offered nationally, and utilization could be negatively impacted, since these organs already accrue cold ischemic time over the straight flight distance from Anchorage to Seattle which totals over 1,250 nautical miles. It is worth noting that in the previous public comment process with respect to the proposal to change kidney allocation policy, the OPTN Minority Affairs Committee stated concerns that Alaska donors would go straight to national allocation, and that this could potentially be an inefficient allocation method. This proposal addresses this concern from the MAC. Finally, we support the proposed plan for post-implementation monitoring, which we believe is an important component of any change in allocation policy. Thank you for the opportunity to comment on this proposal.

Region 4 | 02/20/2020

Strongly support (10), Support (12), Neutral/Abstain (2), Oppose (0), Strongly Oppose (0)

Region 5 | 02/21/2020

Strongly support (11), Support (22), Neutral/Abstain (1), Oppose (0), Strongly Oppose (0) No comments or questions Region 5 supported this proposal

Anonymous | 02/28/2020

6 Strongly Support, 18 Support, 5 Neutral/Abstain, 2 Oppose, 0 Strongly Oppose Members of the region supported the proposal. One member commented that the two committees should monitor utilization of kidneys and pancreata from Hawaiian donors and consider a similar solution. Even though Hawaii does have a transplant hospital the committees a similar solution might be necessary to increase utilization.