At their meeting in December 2006, the OPTN/UNOS Board of Directors approved the replacement of PRA with CPRA in determining kidney and pancreas allocation (policies 22.214.171.124, and 3.8.1).
The Histocompatibility Committee recommended that implementation happen in three phases:
- Phase One: Allocation will continue to be based on traditional PRA, however, OPOs, transplant centers, and HLA laboratories will be able to calculate and see CPRA on the WaitlistSM. Members can access the CPRA calculator on the OPTN and UNOS Web sites.
- Phase Two: Allocation based on CPRA will be initiated, although OPOs, transplants centers, and HLA laboratories will be able to enter and see traditional PRA on the WaitlistSM if desired.
- Phase Three: Allocation will be based on CPRA. Traditional PRA information will no longer appear on the Waitlist.
We implemented phase one in December 2007. We intended to implement Phase Two three to six months later. Unfortunately, because of operational and scheduling-related issues, we will not be able to implement phase two as soon as we had originally planned. Our rescheduled implementation date is set for the second quarter of 2009.
During this delay, personnel at transplant centers, organ procurement organizations, and histocompatibility labs should continue to familiarize themselves with the CPRA policy. You'll find educational tools including a calculator on the OPTN and UNOS websites. During this delay, we will continue to display candidate CPRA on the the Waitlist (but it will not affect allocation) so that transplant professionals can continue to gain experience with this enhancement. When we are ready to implement the CPRA policy and apply it to the match run, we will circulate a Systems Notice.
We appreciate your efforts to educate yourself on this new system and we encourage you to share this information with anyone who may benefit from it. If you have any questions, please contact Lori Gore, UNOS liaison to the Histocompatibility Committee.