SRTR: Upcoming Adjustments to Transplant Program and OPO Evaluation Metrics due to COVID-19 | January 2022 Reporting Cycle

The Scientific Registry of Transplant Recipients (SRTR), under contract from the Health Resources and Services Administration (HRSA), is charged with evaluating the performance of the nation’s solid organ transplant system through publication of semi-annual transplant program-specific reports (PSRs) and organ procurement organization (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 and patient survival.

In response to the COVID-19 pandemic, SRTR modified the evaluation metrics for transplant programs and OPOs for the January 2021 and July 2021 reporting cycles, as previously announced. Potential modifications for the January 2022 reporting cycle were considered at the Analytic Methods Subcommittee of the SRTR Review Committee (SRC) at its meeting on March 24, 2021, and the full SRC meeting on April 27, 2021.

Both the Analytic Methods Subcommittee and the full SRC recommended an ongoing carve out of the first quarter of the pandemic (March 13, 2020 through June 12, 2020) from adjusted performance metrics, as detailed below. These recommendations were reviewed by HRSA’s Division of Transplantation, which oversees SRTR. HRSA approved these recommendations, which SRTR will implement for the January 2022 reporting cycle. These changes will remain in force beyond the January 2022 reporting cycle, unless otherwise amended:

• Posttransplant Outcomes (including 1-month, 1-year, and 3-year graft and patient survival): Evaluation cohorts will exclude transplants performed between March 13, 2020 and June 12, 2020, inclusive of March 13 and June 12. Patients given transplants before March 13, 2020 will have follow-up censored on March 12, 2020. Patients given transplants after June 12, 2020 will resume normal follow-up. Follow-up will not resume for patients given transplants before March 13, 2020 who are alive with function on June 12, 2020; however, this may be reconsidered as SRTR continues to explore moving to a period-prevalent methodology.
  • 1-month and 1-year Patient and Graft Survival Evaluations: For transplants 7/1/2018-3/12/2020, follow-up will continue through 3/12/2020. For transplants 6/13/2020-12/31/2020, follow-up will continue through 6/30/2021.
  • 3-year Patient and Graft Survival Evaluations: For transplants 1/1/2016-6/30/2018, follow-up will continue through 3/12/2020.
• Waitlist Mortality Rate: Evaluation cohorts will exclude March 13, 2020 through June 12, 2020, inclusive of March 13 and June 12.
  • Days after listing (and before transplant) between 7/1/2019-3/12/2020 and 6/13/2020-6/30/2021.
• Transplant Rate: Evaluation cohorts will exclude March 13, 2020 through June 12, 2020, inclusive of March 13 and June 12.
  • Candidates on the waitlist 7/1/2019-3/12/2020 and 6/13/2020-6/30/2021.
• Overall Mortality Rate after Listing: Evaluation cohorts will exclude March 13, 2020 through June 12, 2020, inclusive of March 13 and June 12.
  • Evaluation period: 7/1/2019-3/12/2020 and 6/13/2020-6/30/2021.
• Offer Acceptance Rate: These evaluations are based on normal reporting cohorts.
  • Offers received 7/1/2020-6/30/2021.
• Eligible Death Conversion Rate: These evaluations are based on normal reporting cohorts.
  • Eligible deaths 7/1/2020-6/30/2021.
• Deceased Donor Organ Yield: Deceased donors during the first quarter of the national emergency will be excluded from evaluation.
  • Deceased donors 7/1/2019-3/12/2020 and 6/13/2020-6/30/2021.

These decisions will apply to the evaluations released in the SRTR’s semi-annual PSRs and OSRs scheduled for release in January 2022.

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