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Notices of implemented actions

Implemented

  • 1.2: Definitions
  • 1.4.F: Updates to Candidate Data during 2020 COVID-19 Emergency (Repealed as of 07/27/2021; Reinstated as of 1/11/2022; Expired 4/11/2022)
  • 2.9: Required Deceased Donor Infectious Disease Testing
  • 2.11: Required Deceased Donor Information
  • 3.7.D: Applications for Modification of Kidney Waiting Time during 2020 COVID-19 Emergency
  • 18.1: Data Submission Requirements
  • 18.1.A: Retrospective Data Collection during COVID-19 Emergency
  • 18.2: Timely Collection of Data
  • 18.5.A: Reporting Requirements after Living Kidney Donation
  • 18.5.B: Reporting Requirements after Living Liver Donation

The table below shows Implemented policy notices with detailed Item name, board action date, and effective implementation date

Item Action Effective date
Implemented policy items in 2022
Establish OPTN Requirement for Race-Neutral Estimated Glomerular Filtration Rate (eGFR) Calculations

6/2022 Board action 7/27/2022

Modify Living Donor Exclusion Criteria

  • 14.4.E: Living Donor Exclusion Criteria
 6/2022 Board action 7/26/2022

Ongoing Review of National Liver Review Board (NLRB) Diagnoses

 Split implementation. Additional actions targeted for April 2023 implementation.

 ·         Guidance to Liver Transplant Programs and the National Liver Review Board for Adult MELD Exceptions for Hepatocellular Carcinoma (HCC)

·         Guidance to Liver Transplant Programs and the National Liver Review Board for Adult MELD Exceptions Review

 6/2022 Board action 7/26/2022
Modify Heart Policy to Address Patient Safety Following Device Recall 7/2022 Executive Committee Action 7/14/2022

Enhance Transplant Program Performance Monitoring System, Phase 1 (July 2022)

  • Inquiries related to post-transplant outcomes
 6/2022 Board Action 7/14/2022
Pediatric Candidate Pre-Transplant HIV, HBV, and HCV Testing 6/2022 Board Action 7/1/2022
Calculate Median MELD at Transplant around the Donor Hospital and Update Sorting within Liver Allocation 06/2021 Board Action 06/28/2022
Enhance Transplant Program Performance Monitoring System 12/2021 Board Action Cohorts for pre- transplant metrics begin 1/1/2022

Clarify Multi-Organ Allocation Policy

 06/2021 Board action 02/10/2022
Guidance for Data Collection Regarding Classification of Citizenship Status 12/2021 Board Action 02/01/2022
Ethical Considerations of Continuous Distribution in Organ Allocation

12/2021 Board Action 02/01/2022

Review of National Liver Review Board (NLRB) Diagnoses and Update to Alcohol Associated Diagnoses

  • 9.5.I.i: Initial Assessment and Requirements for HCC Exception Requests
  • 9.5.I.vii: Extensions of HCC Exceptions
  • Guidance to Liver Transplant Programs and the National Liver Review Board for Adult MELD Exceptions for Hepatocellular Carcinoma (HCC)
  • Guidance to Liver Transplant Programs and the National Liver Review Board for Adult MELD Exceptions Review 

 12/2021 Board Action 02/01/2022
Implemented policy items in 2021    
Extending Hawaii Puerto Rico Closed Blood Type Variance  12/2020 Board action

12/6/2021
Extend HIV Organ Policy Equity  (HOPE) Act Variance 12/2020 Board action

12/6/2021

Lower Respiratory SARS-CoV-2 Testing for Lung Donors

 4/26/2021 Executive Committee Action; 12/2021 Board action

5/27/2021
Update to Refusal Codes 6/2021 Board action 12/2/2021

Further Enhancements to the NLRB

  • Policy 9.5.G: Requirements for Portopulmonary Hypertension MELD or PELD Score Exceptions
  • National Liver Review Board Operational Guidelines
  • Guidance to Liver Transplant Programs and the National Liver Review Board for Adult MELD Exception Review
 12/2020 Board action 10/07/2021

Updating National Liver Review Board Guidance and Policy Clarification

  • Policy 9.5.A: Requirements for Cholangiocarcinoma (CCA) MELD or PELD Score Exceptions
 06/2021 Board action

10/07/2021

Refine Lung Data Fields 

 07/2021 Executive Committee Action

09/30/2021

Updated Cohort for Calculation of the LAS

 12/2020 Board action

09/30/2021

Require Notification of Critical Human Leukocyte Antigen (HLA) Typing Changes

 06/2021 Board action

09/01/2021

Modify Living Donor Policy to Include Living VCA Donors

 06/2021 Board action

09/01/2021

Updating National Liver Review Board Guidance and Policy Clarification

  • Guidance to Liver Transplant Programs and the National Liver Review Board for Pediatric MELD or PELD Exception Review
  • Guidance to Liver Transplant Programs and the National Liver Review Board for Adult MELD Exception Review
 06/2021 Board action

07/15/2021

Human Leukocyte Antigen (HLA) Equivalency Tables Update 2020

 06/2020 Board action

06/17/2021

National Heart Review Board for Pediatrics

 06/2020 Board action

06/15/2021

Clarification of Policies and Bylaws Specific to Vascularized Composite Allografts

 06/2021 Board action

06/14/2021

Combined Policy Notice for VCA Membership Requirements (2020)

 

VCA - List Covered Body Parts - 1 of 2

  • Policy 1.2: Definitions
  • Bylaws Appendix D: Membership Requirements for Transplant Hospitals and Transplant Programs; Appendix J: Membership Requirements for Vascularized Composite Allograft (VCA) Transplant Programs; and Appendix M: Definitions

 

Align VCA program membership requirements with other programs

 

Membership Requirements for VCA Transplant Programs

06/2015, 06/2016, 06/2018 Board action

06/14/2021

Align OPTN Policy with US PHS Guideline 2020

  • Policy 14.3: Informed Consent Requirements
  • Policy 14.8.B: Living Donor Specimen Collection and Storage

12/2020 Board action

06/01/2021

Expedited Liver Placement

 12/2019 Board action 03/25/2021

Pancreas Removal of DSA

 12/2019 Board action 03/15/2021

Kidney Removal of DSA

 12/2019 Board action 03/15/2021

Addressing Medically Urgent Candidates in New Kidney Allocation Policy

 06/2020 Board action 03/15/2021

Distribution of Kidneys and Pancreata from Alaska

 06/2020 Board action 03/15/2021

Modifications to Released Kidney and Pancreas Allocation

 06/2020 Board action 03/15/2021

Guidance and Policy Addressing Adult Heart Allocation

  • Policy 6.1.A.ii: Non-dischargeable, surgically implanted, non-endovascular biventricular support device: Effective March 4, 2021
  • Policy 6.1.C.vi: Mechanical Circulatory Support Devise (MCSD) with Device Infection: Effective March 4, 2021
  • Policy 6.1.D.ii: Inotropes without Hemodynamic Monitoring: Effective March 4, 2021
  • Guidance for Adult Heart Exceptions for
    Status 2 Candidates Experiencing Cardiogenic Shock: Effective February 9, 2021
 12/2020 Board action 02/09/2021, 03/04/2021

Align OPTN Policy with US PHS Guideline 2020

Split implementation. Additional actions targeted for June 2021 implementation.

  • 1.2: Definitions
  • 2.2: OPO Responsibilities
  • 2.4: Deceased Donor Medical and Behavioral History
  • 2.5: Hemodilution Assessment
  • 2.7.A: Exceptions to HIV Screening Requirement
  • 2.9: Required Deceased Donor Infectious Disease Testing
  • 13.11:  Receiving and Accepting KPD Match Offers
  • 14.1.A: Living Donor Psychosocial Evaluation Requirements
  • 14.4.A: Living Donor Medical Evaluation Requirements
  • 14.9.B: Psychosocial and Medical Evaluation Requirements for Domino and Non-Domino Therapeutic Donors
  • 15.2:  Potential Candidate Screening Requirements
  • 15.3.B: Donors with  Risk Identified Pre-Transplant
  • 15.3.C: Recipients of Organs from Donors with   Increased Risk of Disease Transmission
  • 16.3.D: internal labeling of Extra Vessels
 12/2020 Board action 03/2021

Guidance Addressing the Use of Pediatric Heart Exceptions

 12/2020 Board action 02/09/2021
Further Enhancements to the National Liver Review Board
  • Split implementation. Additional actions targeted for June 2021 implementation.
  • Guidance to Liver Transplant Programs and the National Liver Review Board for Adult MELD Exception Review
 12/2020 Board action 02/09/2021
Implemented policy items in 2020    
Establish Pediatric Training and Experience 12/2015 Board actions 12/07/2020
Revise Pediatric Emergency Membership Exception Pathway 12/2017 Board action 12/07/2020
Incorporating COVID-19 Related Organ Failure In Candidate Listings 10/2020 Board action 10/28/2020
Enhancements to the National Liver Review Board
  • Policies 9.4.A: MELD or PELD Score Exception Requests and 9.4.D: Calculation of Median MELD or PELD at Transplant: Effective August 4, 2020
  • Operational Guidelines: Effective August 4, 2020
  • Operational Guidance: Effective August 4, 2020
  • Policies 9.4.C: MELD or PELD Score Exception Extensions and 9.5.I.vii: Extensions of HCC Exceptions: Effective September 10, 2020
 06/2020 Board action 08/04/2020, 09/10/2020
Guidance and Policy Modifications Addressing Blood Type Determination
  • Guidance: Effective June 8, 2020
  • Policy: Effective September 1, 2020
 06/2020 Board action 06/08/2020,09/01/2020
Modify the Conflicts of Interests Bylaws 06/2020 Board action 07/01/2020
Creation of OPTN Heart and Lung Committees 03/2020 Board action 07/01/2020
Modify Lung TRF to Improve Post Transplant Lung Function Data 06/2018 Board action 06/30/2020
Eliminate the Use of Regions in VCA Distribution 06/2019 Board action 06/18/2020
Modify HOPE Act Variance to Include Other Organs 06/2019 Board action 05/21/2020
COVID-19 Emergency Policy Package 04/2020 Executive Committee action 04/03/2020
Clarifications on Reporting Maintenance Dialysis 06/2019 Board action 04/01/2020
Updates to Candidate Data During 2020 COVID-19 Emergency 03/2020 Executive Committee action 03/17/2020
Variances Removal Policy Notice 12/2019 Board action 03/01/2020
Clarification of Pre-Existing Liver Disease 12/2019 Board action 03/01/2020
Addressing HLA Typing Errors 12/2018 Board action 02/27/2020
Access for Urgent Liver Candidates in Hawaii & Puerto Rico 01/2020 Executive Committee action 02/18/2020
Liver and Intestine Distribution Using Distance from Donor Hospital 12/2018 Board action 02/04/2020
Reduce Reporting Burdens and Clarify Policies on Extra Vessels
  • Table 16.1: Required information on internal labels for extra vessels, number 7 (donor infectious disease results)
 06/2018 Board action 01/29/2020
Update Transplant Hospital Definition 12/2016 Board action 01/13/2020
Eliminate the Use of DSAs in Thoracic Organ Distribution 06/2019 Board action 01/09/2020
Implemented policy items in 2019    
Adding DR Antigens and Equivalences 12/2019 Board Action 12/04/2019
Hope Act Policy and Mini Brief 12/2019 Board action 12/03/2019
Modify Appointment Process for the Histocompatibility Vice Chair 12/2019 Board Action 12/03/2019
Aligning Units of Distribution in Closed Variance for Split Liver Transplantation 12/2019 Board Action 12/03/2019
Split Liver Variance 06/2019 Board action 12/03/2019
Revising Priority Points in Kidney Paired Donation Program 12/2015 Board action;
10/2019 Executive Committee action		 10/24/2019
Improving Dual Kidney Allocation 12/2017 Board action 9/2019
Improving en Bloc Kidney Allocation 12/2017 Board action 9/2019
Changes to Waiting Time Criteria for Kidney-Pancreas Candidates 06/2018 Board action 7/11/2019
Guidance on Effective Practices in Organ Distribution 06/2019 Board action 6/10/2019
Ethical Implications of Multi-Organ Transplants White Paper 06/2019 Board action 6/10/2019
Revised National Liver Review Board Policies 12/2018 Board action 5/14/2019
National Liver Review Board 06/2017 Board action 5/14/2019
Histocompatibility Bylaws Rewrite: General Supervisor 06/2015 Board action 3/1/2018
Pancreas Program Functional Inactivity 12/2018 Board action 4/8/2019
Addressing HLA Typing Errors
  • Policy 2.2 (OPO responsibilities)
  • Bylaws C.2.D (OPO affiliation)
 12/2018 Board action 3/1/2019
Amend CPRA Calculator 01/2019 Executive Committee action 1/17/2019
Implemented policy items in 2018    
Change to Hospital-Based OPO Voting Privileges 12/2018 Board action 12/4/2018
Frameworks for Organ Distribution 12/2018 Board action 12/4/2018
Pediatric Transition and Transfer Guidance 12/2018 Board action 12/3/2018
Intestine Membership Bylaws Requirements 06/2015 Board action 11/20/2018
Modify Adult Heart Allocation 12/2016 Board action 10/18/2018
Clarification of Adult Heart Allocation 08/2017 Executive Committee action 10/18/2018
Review Board Guidance on HCM and RCM Exceptions 06/2018 Board action 10/18/2018
Modifications to the Distribution of Deceased Donor Lungs 06/2018 Board action 10/18/2018 (Policy 6.6.F)
06/12/2018 (Policies 1.2, 10.2.A, 10.4)
Clarify Informed Consent Policies for Transmittable Diseases 06/2018 Board action 09/01/2018
Reduce Reporting Burdens and Clarify Policies on Extra Vessels 06/2018 Board action 09/01/2018 (except table 16.1)
VCA - List Covered Body Parts (2 0f 2)
  • Bylaws Appendix J: Membership Requirements for Vascularized Composite Allograft (VCA) Transplant Programs: Effective September 1, 2018
  • Policy 1.2: Definitions: Target implementation date: December 2021
  • Bylaws Appendix D: Membership Requirements for Transplant Hospitals and Transplant Programs; Appendix J: Membership Requirements for Vascularized Composite Allograft (VCA) Transplant Programs; and Appendix M: Definitions: Target implementation date: December 2021
 06/2016 Board action 09/01/2018
Improving the Efficiency of Organ Allocation 12/2017 Board action 03/01/2018 (Policies 2.2, 2.11 and 2.12)
05/02/2018 (Policies 1.2 and 5.6.B)
06/12/2018 (Policies 2.11.A and 2.11.D)
06/13/2018 (Policy 5.6.C)
Revising OPTN Bylaws Appendix L 06/2018 Board action 06/12/2018
Retrospective Review of Clerical Policy Changes 06/2018 Executive Committee action 06/12/2018
Approved Transplant Fellowship Training Programs Bylaws 12/2017 Board action 03/01/2018
Definition of Pancreas Graft Failure 06/2015 Board action 2/28/2018
Modification to HCC Extension Criteria   2/5/2018
Implemented policy items in 2017    
HCC Auto Approval Criteria Changes 12/2016 Board action
12/2017 Executive Committee action		 12/12/2017
Lung Allocation Policy Modification 11/2017 Executive Committee action 11/24/2017
Standardize Organ Coding and Tracking System 2/2017 Executive Committee action 11/01/2017
Improve the Categorization of Living Donor Events 9/2017 executive committee action 10/18/2017
Add DQA-1 Equivalences Table 6/2016 Board action
6/2017 Executive Committee action		 09/12/2017
Update HLA Equivalency Tables 12/2015 Board action
4/2017 Executive Committee action		 09/12/2017
Personnel Procurement Requirements 12/2015 Board action 09/01/2017
Foreign Equivalent in Bylaws 12/2015 Board action 09/01/2017
Bylaws Rewrite 06/2017 Board action 09/01/2017
Primary Kidney Transplant Physician Update 12/2016 Board action 09/01/2017
Clarification to Apply Kidney Minimum Acceptance Criteria to Highly Sensitized Candidates 07/2017 Executive Committee action 09/01/2017
Simultaneous Liver-Kidney Allocation 06/2016 Board action 08/10/2017
Kidney: KAS Clarifications (part) 06/2016 Board action 06/29/2017
Retrospective Review of Clerical Changes to Policies 06/2017 Executive committee action 06/29/2017
Informed Consent Changes - Potential Living Donors 12/2016 Board action 06/01/2017
Improving Post-Transplant Communication (part) 06/2016 Board action; Required toxoplasmosis testing of all donors 04/06/2017
Pediatric Lung Allocation Changes 12/2015 Board action 03/30/2017
All Other KPD Guidelines to Policy (part) 06/2015 Board action 03/30/2017
Post-Implementation ABO Policy Changes 12/2016 Board action 03/01/2017
Primary Transplant Surgeon Changes 12/2016 Board action 03/01/2017
Primary Transplant Physician Subspecialty Changes 12/2016 Board action 03/01/2017
Remove Donor Location from Required Procurement Log 12/2016 Board action 03/01/2017
Changes to Imminent and Eligible Definitions 12/2016 Board action 01/01/2017
Implemented policy items in 2016    
Retrospective Review of Clerical Changes to Policies 12/2016 Executive committee action 11/10/2016
Registration Fee 06/2016 Board action 10/01/2016
DTAC Policy Clarification 06/2016 Executive Committee action 09/01/2016
OSC Policy Clarification 08/2016 Executive Committee action 09/01/2016
HOPE Act 06/2016 Board action 09/01/2016
Improving Post-Transplant Communication (part) 06/2016 Board action 09/01/2016
Kidney: KAS Clarifications (part) 06/2016 Board action 09/01/2016
Regional Councillor Vacancy 06/2016 Board action 09/01/2017
Living Donor Candidate Registration 04/2016 Executive Committee action 04/14/2016
Retrospective Review of Clerical Changes to Policies 12/2016 Executive committee action 4/14/2016
Implemented policy items in 2015    
KPD Informed Consent 06/2015 Board action 12/01/2015