Frameworks for Organ Distribution
Sponsoring Committee: Ad Hoc Geography
Strategic Goal: Promote the efficient management of the OPTN
Read the policy notice (PDF; 1/2019)
View the board briefing paper (PDF; 12/2018)
Proposal executive summary
The Ad Hoc Geography Committee was formed in December 2017 to examine the geographic distribution of organs. The Committee was charged with:
- Establishing defined guiding principles for the use of geographic constraints in organ allocation
- Reviewing and recommending models for incorporating geographic principles into allocation policies
- Identifying uniform concepts for organ specific allocation policies in light of the requirements of the OPTN Final Rule
The OPTN Final Rule sets requirements for allocation polices developed by the OPTN, including sound medical judgement, best use of organs, the ability for centers to decide whether to accept an organ offer, to avoid wasting organs, and to promote efficiency.1 The Final Rule also includes a requirement that policies “shall not be based on the candidate’s place of residence or place of listing, except to the extent required” by the other requirements of the Rule.
On June 11, 2018, the OPTN/UNOS Board of Directors adopted principles to guide future organ transplant policy relating to geographic aspects of organ distribution. Additionally, the Board of Directors accepted the Ad Hoc Geography Committee’s recommendation to request community feedback on the recommended distribution frameworks, with a goal of identifying a single, preferred distribution framework to be used across organs. This proposal includes three distribution frameworks identified by the Ad Hoc Geography Committee as being in alignment with the adopted principles of geographic distribution and the OPTN Final Rule.
1 42 C.F.R. §121.8(a)
Read the proposal (PDF – 482 K; 8/2018)
The Ad Hoc Geography Committee requests feedback from the community regarding the three distribution frameworks. The goal is to identify a single framework to be used across organs. The community is encouraged to provide their rationale for preferring one specific framework of the three proposed.
Members are asked to comment on both the immediate and long term budgetary impact of resources that may be required by the distribution frameworks. This information assists the Board in considering the proposal and its impact on the community.