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Modifications to Released Kidney and Pancreas Allocation

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 new kidney and pancreas allocation policies that are based on a 250 nautical mile (NM) circle, and will be implemented simultaneously with them in late 2020.

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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 included 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 policy (250 NM circle around intended recipient hospital)
    • Contact the OPTN for assistance
    • Find a visual aid for allocation of released kidneys below, under Guidance
  • Released kidney-pancreas, pancreas and islets: The host OPO has the following options:
    • Continue allocation using original match run
    • Allocate to a potential transplant recipient at accepting center. If a pancreas-alone, allocate kidney according to released kidney policy
    • Contact the OPTN for assistance
    • Find a visual aid for allocation of released pancreas and kidney-pancreas below, under Guidance
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 proposed language will 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 resources are in development for this policy implementation—check back for more information as is becomes available.

Guidance

Frequently asked questions

  • Additional resources are in development for this policy implementation—check back for more information as is becomes available.

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