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Modifications to Released Kidney and Pancreas Allocation

New policies to remove DSA and region from kidney and pancreas allocation now in effect. Learn more.

This policy creates a process for reallocation of released organs when an original intended recipient is unable to be transplanted. This process aligns with the distance-based kidney and pancreas allocation policies approved by the board in December 2019.

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Background

At its December 2019 meeting, the OPTN Board of Directors approved a policy to remove donation service area (DSA) and region from kidney and pancreas allocation. These changes require the modification of policies related to the reallocation of released kidneys and pancreata, including Policy 5.9: Released Organs.

At its June 2020 meeting, the OPTN Board of Directors passed an additional policy developed by the OPTN Organ Procurement Organization Committee, addressing the reallocation of kidney, kidney-pancreas, pancreas, and islets in situations in which an organ allocated to an original intended recipient is unable to be transplanted in that recipient. These policies include the use of a 250 NM reallocation circle around the transplant hospital that originally accepted the organ(s).

Policy

Summary of policy changes

For OPOs:

Released kidneys: The host OPO has the following options:

  • Continue allocation using original match run
  • Allocate kidney using released kidney match run (250 NM circle around intended recipient hospital)
  • Find a PDF of the process for allocation of released kidneys under Guidance
  • The host OPO may also contact the OPTN for assistance

Released pancreas: The host OPO has the following options:

  • Continue allocation using original match run
  • Allocate pancreas to a potential transplant recipient at the accepting center
  • Find a PDF of the process for allocation of released kidneys under Guidance
  • The host OPO may also contact the OPTN for assistance

Released kidney-pancreas: The host OPO may keep the kidney-pancreas together or split the kidney-pancreas:

  • If they keep the kidney-pancreas together, the host OPO may continue allocation using original match run OR allocate to a potential kidney-pancreas transplant recipient at accepting center
  • If they split the kidney-pancreas, the host OPO must allocate kidney according to released kidney policy AND may allocate the pancreas to a potential transplant recipient at the accepting center
  • Find a PDF of the process for allocation of released kidneys under Guidance
  • The host OPO may also contact the OPTN for assistance
For transplant programs:
  • The transplant program must immediately notify the host OPO or OPTN when an organ allocated to an original intended recipient is unable to be transplanted in that recipient.
  • Find additional details about implementation in the policy notices below.

Policy documents

Post-implementation monitoring

The language does not change the current routine monitoring of OPTN members. In addition to the monitoring described below, all policy requirements and data entered in UNetSM may be subject to OPTN review, and members are required to provide documentation as requested. OPTN staff will continue to review all deceased donor match runs that result in a transplanted organ to ensure allocation was carried out according to OPTN organ specific policies and will continue to review any allocation deviations. OPTN staff will inquire with OPOs and transplant programs, as applicable, for additional information when a deviation is identified. The MPSC will review all relevant information to determine if a policy noncompliance has occurred and what type of action, if any, is warranted.

FAQs & resources

Instruction

  • Professional education on modifications to released kidney and pancreas allocation is available on UNOS Connect.

    • KID111: Modifications to Released Kidney and Pancreas Allocation
    • KID112 - Removing DSA and Region from Kidney and Pancreas Allocation

Guidance

Frequently asked questions

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