Deceased kidney donors recovered increase six-months post-implementation minimum donor criteria for kidney biopsies

Published on: Tuesday, December 19, 2023

A new data monitoring report evaluates key measures of a policy that went into effect Sept. 6, 2022. The policy aimed to standardize biopsy practices by establishing minimum donor criteria for when kidney biopsies must be performed by an organ procurement organization (OPO). These changes were projected to streamline communication between OPOs and transplant hospitals and improve kidney allocation efficiency.

The most recent monitoring report presents six months of post-implementation data. This early data shows a six percent increase (6, 930) of deceased kidney donors recovered in the post-policy era¹ compared to the pre-policy era² (6, 528).

Additional key data points include:

• The percentage of donors being biopsied stayed similar between the pre- and post-policy era (62.6 percent pre-policy vs. 63.9 percent post-policy)
• The non-use rate of kidneys overall, increased by three percent (26.5 percent pre-policy vs. 29.7 percent post policy)

From the analysis performed in the report, there has not been a substantial increase in the percentage of donors being biopsied after this policy change; however, there were small shifts in the types of donors that are being biopsied. While it appears the non-use rate for kidneys is increasing overall, there have been shifts in the type of donors being recovered as well as being biopsied, suggesting there is not sufficient evidence to indicate use of biopsies alone has increased non-use rates.

Continued monitoring and looking ahead

The report was presented to the OPTN Kidney Transplantation Committee at their Oct. 11, 2023 meeting. The Committee will continue to monitor the policy to understand whether the changes are meeting the intended goals, and to determine if they are resulting in unintended consequences. The next planned monitoring report will be at the one-year post policy mark as outlined in the policy’s briefing paper.

Kidney and pancreas organ types are currently moving through a series of steps to adopt a framework known as continuous distribution that was first adopted by lung in March 2023. Recently, the OPTN Board of Directors directed the Kidney and Pancreas Committee to incorporate additional considerations regarding non-use and alternate allocation pathways for kidneys at high risk of non-use. The Committees will work to incorporate these considerations as they continue the continuous distribution of kidneys and pancreata.

¹ The post-policy era was defined as Sept 6, 2022 to March 5, 2023.

² The pre-policy era was defined as March 9, 2022 to Sept. 5, 2022.