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SRTR announces monitoring changes for July 2021 reports in response to COVID-19

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UNOS News Bureau

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The semi-annual transplant program-specific reports (PSRs) and organ procurement organization (OPO)-specific reports (OSRs) published by the Scientific Registry of Transplant Recipients will be adjusted for the July 2021 reporting cycle. These changes were developed in coordination with the Organ Procurement and Transplantation Network’s Membership and Professional Standards Committee, which evaluates and supports OPTN members by providing feedback on and recommendations to improve members’ performance, compliance and quality systems.

The SRTR, under contract from the Health Resources and Services Administration, is charged with evaluating the performance of the nation’s transplant system through publication of PSRs and OSRs. These reports contain performance metrics covering various time periods. For OPOs, these metrics include eligible death conversion rates and deceased donor organ yield. For transplant programs, they include waitlist mortality rates, transplant rates, organ offer acceptance rates, patient mortality after listing, and 1-month, 1-year, and 3-year post-transplant outcomes including graft survival and patient survival.

In response to the current global pandemic, SRTR previously modified the evaluation metrics for transplant programs and OPOs for the reports released in January 2021. The reports released in January 2021 made adjustments to transplant program and OPO performance metrics so that data beyond the declaration of a national public health emergency on March 13, 2020, were not included in the metrics.

The SRTR Review Committee reviewed the metrics earlier this year with the goal of determining whether continued adjustments are necessary, or if the SRTR should resume regular reporting of transplant program and OPO performance metrics. The committee reviewed data on how the pandemic has affected the nation’s transplant system, and the extent to which the effects varied geographically and temporally. The committee made the following recommendations, which were reviewed by the HRSA’s Division of Transplantation, which oversees the SRTR. HRSA approved of these recommendations which the SRTR will implement for the July 2021 reporting cycle:

  • Post-transplant outcomes (including 1-month, 1-year, and 3-year graft and patient survival): Evaluations cohorts will continue to exclude transplants and follow-up time beyond March 12, 2020.
    • 1-month & 1-year Patient and Graft Survival Evaluations: Transplants 1/1/2018-3/12/2020; follow-up through 3/12/2020.
    • 3-year Patient and Graft Survival Evaluations: Transplants 7/1/2015-12/31/2017; follow-up through 3/12/2020.
  • Waitlist mortality rate: Evaluation cohorts will be modified on an organ-specific basis.
    • Kidney and Lung: Candidates on the waitlist 1/1/2019-3/12/2020.
    • Liver, Heart, Pancreas, and Intestine: Candidates on the waitlist 1/1/2019-12/31/2020.
  • Transplant rate: The first quarter following declaration of a national emergency will be excluded from the transplant rate evaluations for all organ types.
    • Candidates on the waitlist 1/1/2019-3/12/2020 and 6/13/2020-12/31/2020.
  • Overall rate of mortality after listing: Patient follow-up will continue to be truncated on 3/12/2020:
    • Evaluation period: 1/1/2019-3/12/2020.
  • Offer acceptance rate: These evaluations will return to normal reporting cohorts.
    • Offers received 1/1/2020-12/31/2020.
  • Eligible death conversion rate: Eligible deaths during the first quarter of the national emergency will be excluded from evaluation.
    • Eligible deaths 1/1/2020-3/12/2020 and 6/13/2020-12/31/2020.
  • Deceased donor organ yield: Deceased donors during the first quarter of the national emergency will be excluded from evaluation.
    • Deceased donors 1/1/2019-3/12/2020 and 6/13/2020-12/31/2020.

These decisions will apply to the evaluations released in the SRTR’s semi-annual program-specific reports scheduled for release on July 6, 2021. These decisions will then be re-evaluated as more information becomes available in preparation for the release scheduled for January 2022.

As with the January 2021 reports, SRTR will continue to report descriptive data beyond March 12, 2020, e.g., waitlist counts, transplant counts, recipient characteristics, donor counts, donor characteristics, etc., but will alter data for performance evaluation metrics as described above.

Please email srtr@srtr.org with any questions about the adjustments to PSRs or OSRs.

Contact MQFeedback@unos.org with questions about OPTN member monitoring.