Pilot projects to speed deceased donor organ allocation

I won't use the word "experiments" for fear of the evil eye, but the OPTN is planning to authorize 'pilot programs' to try to speed the allocation of deceased donor organs. The idea is that after an organ has been rejected numerous times, and has started to be in danger of discard, it can be offered to a transplant center and patient that are likely to accept and transplant it, rather than proceeding to offer it to centers and patients in priority order. This is important, because too much waiting time on ice is one of the chief reasons that organs are rejected and eventually discarded.

Expedited Placement Variance his proposal recommends a new variance related to expedited organ placement and proposes modifying the OPTN’s variance process in order to allow for more rapid studies of potential improvement.

"Proposed changes

"Create a variance to govern pilot projects related to expedited organ placement.

Gives the OPTN Executive Committee authority to develop protocols for expedited organ placement.

This approach will allow the OPTN the ability to rapidly iterate on different protocols.

Update portions of the OPTN’s governance structure regarding variances.

This will allow for a more rapid and iterative approach when creating new variances."

Read the full proposal (PDF)

"The task force intends to conduct multiple iterative pilots or PDSAs with the community to identify effective practices to improve the efficiency of the organ allocation process. (Not all pilots or PDSAs will require a policy variance.) This proposal 1) creates a variance to govern the expedited placement pilots and 2) adjusts the OPTN’s governance of all variances. Additional variances or process improvement projects will focus on other topics to improve the efficiency of the organ allocation process.

"The Committee is issuing this proposal for a thirty-day public comment period, which is shorter than the usual public comment period. This is to allow the variance to take effect sooner than the end of regular public comment but allow the community time to comment on the proposed variance. It also is in line with the public comment periods for emergency and expedited policy changes."