COVID-19 Changes: Upcoming Adjustments to Transplant Program and OPO Evaluation Metrics

Friday, August 7, 2020

In light of the current global pandemic, the Scientific Registry of Transplant Recipients (SRTR) will be modifying the evaluation metrics for transplant programs and organ procurement organizations. Following the declaration of a national public health emergency on March 13, 2020, COVID-19 has had a large impact on the transplant system. The reports scheduled for release in January 2021, with data presented through June 30, 2020, will be the first to cover the performance period after March 13, 2020.

The SRTR Visiting Committee reviewed preliminary data on the impact of the pandemic at its meeting on July 7, 2020, with the goal of considering changes to upcoming reports. Preliminary data suggest that the pandemic has had a differential effect on different areas of the country at different times, making it a challenge to deal with statistically until more data becomes available. SRTR’s recommendation to the Visiting Committee was to remove any patient and donor data from the performance metrics following the declaration of a national emergency on March 13, 2020.

For transplant programs, this means that SRTR will stop all patient follow-up on March 12, 2020, the day prior to the declaration, i.e., waitlist survival, transplant rate, and outcomes will not be assessed after that date. For OPOs, SRTR will not evaluate eligible death conversion rates or deceased donor organ yield past March 12, 2020.

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 exclude data from performance evaluation metrics, e.g., waitlist mortality rate ratios, transplant rate ratios, overall survival from listing rate ratios, offer acceptance rate ratios, and posttransplant patient and graft survival rate ratios. SRTR emphasizes that the Visiting Committee and the Health Resources and Services Administration will continue to evaluate this solution to determine future changes as the pandemic continues to evolve and SRTR can investigate alternative solutions.

The SRTR, under contract from HRSA, is charged with evaluating the performance of the nation’s transplant system through publication of semi-annual transplant program-specific reports (PSRs) and OPO-specific reports (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 posttransplant outcomes including graft survival and patient survival.

For questions and comments, please contact SRTR.