Two new kidney policy monitoring reports available; policy changes projected to streamline communications, standardize biopsy practices
Published on: Friday, March 7, 2025
Two new Organ Procurement and Transplantation Network (OPTN) data monitoring reports evaluate key measures of two related kidney policies that recently went into effect.
The first policy, implemented on Sept. 6, 2022, standardizes biopsy practices by establishing minimum donor criteria for when an organ procurement organization (OPO) must order a kidney biopsy. These changes are projected to streamline communication between OPOs and transplant hospitals and improve kidney allocation efficiency.
The second policy, implemented Sept. 14, 2023, standardizes the data that must be reported by transplant programs when a kidney procurement biopsy is performed. These changes are projected to result in better information sharing around the results of kidney biopsies and lead to more informed decision-making through the offer acceptance process.
Two-year monitoring report: Establish minimum kidney donor criteria to require biopsy
The most recent monitoring report presents two years of post-implementation data. In the post-policy era, there was an 18.7 percent increase in the number of adult deceased kidney donors recovered compared to the pre-policy era.1
Additional key points include:
- There was a slight increase in the percentage of deceased donors who had at least one kidney biopsied, increasing from 64.01% to 65.81% in the post-policy era
- Non-use rates increased by 5.31% from the pre- to post-policy era for kidneys recovered from biopsied donors (36.38% in the pre-policy era vs. 41.69% in the post-policy era)
- There was a 3.87% increase in non-use overall (25.65% vs. 29.52%)
One-year monitoring report: Standardize kidney biopsy reporting and data collection
The most recent monitoring report presents one year of post-implementation data. In the post-policy era, there was a 5.3 percent increase in kidneys biopsied.2
Additional findings include:
- Kidneys that were biopsied saw little change in non-use rates between the two eras, with around 49% of biopsied kidneys not used for transplant in both policy eras
- The majority of biopsied kidneys in the post-policy era utilized a wedge biopsy as the biopsy method, and did not report findings of interstitial fibrosis and tubular atrophy (IFTA), vascular disease, arteriolar hyalinosis, cortical necrosis, fibrin thrombi, or nodular mesangial glomerulosclerosis
Looking ahead
The OPTN Kidney Transplantation Committee received presentations about both reports on Feb. 10, 2025.
- This was the final planned monitoring report for the Establish Minimum Kidney Donor Criteria to Require Biopsy policy as outlined in the policy’s briefing paper.
- The Committee will continue to monitor the Standardize Kidney Biopsy Reporting and Data Collection 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 released at approximately two years post-policy implementation.
Additional OPTN kidney policy monitoring reports can be found on the kidney & pancreas professionals page on the OPTN website.
1 Policy eras were defined as the following, so each era had the same number of days:
- Pre-policy: September 05, 2020, to September 05, 2022
- Post-policy: September 06, 2022, to September 05, 2024
2 Policy eras were defined as the following:
- Pre-policy: September 13, 2022, to September 13, 2023
- Post-policy: September 14, 2023, to September 13, 2024