Added graft survival for recipients when the donor underwent normothermic regional perfusion/when the donor was COVID-19 positive.
Added non-use and non-utilization rates for donors who underwent normothermic regional perfusion/when the donor was COVID-19 positive.
Added deceased donor transplant rates/waitlist mortality rates for kidney after liver (KAL) safety net candidates.

Questions? Contact us.

Posted: 3/25/2024

2022 Annual Data Report (ADR) Now Live

The 2022 Annual Data Report (ADR) is now live! The ADR provides national statistics and describes trends in donation and transplantation, and is produced by the Organ Procurement and Transplantation Network (OPTN) and the Scientific Registry of Transplant Recipients (SRTR). This thirty-second annual report is based on data pertaining to the period 2011-2022. It covers the most recent complete year of transplants, those performed in 2022. The ADR is accessible through srtr.transplant.hrsa.gov and is also available via the American Journal of Transplantation.

Posted: 3/1/2024

Lung National Center-Level Summary Data Sheets Have Been Updated

The variable that indicates if extra vessels were used was removed from consideration in the Lung, Adult 1- and 3-year graft and patient survival models. The National Center-Level Summary Sheets were created from an intermediate output table from the risk adjustment models prior to the update that removed this variable from consideration. All publicly available PDFs and the securely released reports already include the adjusted values for the lung models, and only the summary data sheets were recently adjusted. If you have any questions about this update, please contact us.

Posted: 2/1/2024

Now Live: Donation and Transplant System Explorer

SRTR is pleased to share the latest donation and transplant-related application in progress: the Donation and Transplant System Explorer. The transplant system in the United States is in constant flux—policies change, practices evolve, and technologies develop. The purpose of the Donation and Transplant System Explorer is to monitor the national transplant system through these changes to describe where we have been, where we are, and where we are going.

Typically, focus is on only one aspect of our system. With this tool, SRTR hopes to provide a more holistic view of the transplant system in the United States, allowing the user to view it from many different perspectives. After identifying a trend in our transplant system, the real work of understanding the cause of that trend begins. That work is left to the many talented researchers in our field. Ultimately, our goal is that the Donation and Transplant System Explorer will enable our transplant community to better serve our patients and honor the generous gifts of our organ donors and donor families.

If you have any questions or comments about this application, please reach out by contacting us.

Posted: 1/24/2024

Confidence Intervals Added to Interactive Fall 2023 PSRs/OSRs

Confidence intervals (95%) have been added for all posttransplant estimated probabilities of surviving with a functioning graft (graft survival), and estimated probabilities of surviving (patient survival). This adjustment is included in the PDF tables released publicly on January 9 and is now included in the web-based tables (interactive reports).

Posted: 1/12/2024

Now Available: Fall 2023 PSRs/OSRs

Find the latest program-specific and OPO-specific reports on our website. In addition to the traditional PDF format, these reports are also available in our interactive, mobile-friendly format.

This adjustment is included in the PDF tables released publicly on January 9 and will be included in the web-based tables in the near future.

Stay up to date on PSR and OSR reporting timelines by visiting our website.

Posted: 1/9/2024

More Frequent Model Rebuild

In the Analytical Methods Subcommittee (AMS) meetings, SRTR has been discussing the possibility of moving to a more frequent model rebuilding process. The current process rebuilds models every few years but refits models every 6 months. The purpose of rebuilding every cycle would be to ensure that new, potential donor, candidate, and recipient variables are being included in the risk adjustments. For more information about the model rebuilding process, review the March 2023 AMS Minutes. The SRTR AMS voted to implement this change for the January 2024 program-specific reports (PSRs), and this model rebuilding process will be implemented for the posttransplant metrics during the upcoming fall 2023 data review cycle.

This more frequent model rebuilding is currently applied to offer acceptance. It will also be phased into the pretransplant and mortality after listing metrics in the near future as well.

There is no plan to preview the models, because all variables are considered each build and those not chosen in the model are considered to have a 0 coefficient. This is not a new process, but more so a streamlining of SRTR’s current process.

The data review period process will remain the same. The only change will be that programs will be able to see all the raw data fields that come from the TIEDI forms, not just those that may be used in the models. This may create a possibility of extra variables being included in the data integrity reports.

During the first application of the new models to the data, programs may see a shift in how some data present, especially in the cumulative sum (CUSUM) charts. However, this happens whenever a model change occurs. With each cycle, data presentation will shift less as the models retain their consistency.

In monitoring efforts, programs can predict and/or benchmark potentially changing variables by allowing for inclusion of all variables each run. Programs would simply implement 0 coefficients for variables not used each run.

Questions about this update? Contact us.

Posted: 9/11/2023

Now Available: Spring 2023 PSRs/OSRs

Find the latest program-specific and OPO-specific reports on our website. In addition to the traditional PDF format, these reports are also available in our interactive, mobile-friendly format. If you have questions, don’t hesitate to contact us.

Stay up to date on PSR and OSR reporting timelines by visiting our website.

Posted: 7/6/2023

Update on OSRs

The draft release of the OSRs is now live. Read the reason for delay below.

Posted: 4/4/2023

Delay and Changes to the Draft Release of SRTR’s Organ Procurement Organization (OPO)-specific Reports

Release Originally Scheduled for April 1, 2023

The draft release of SRTR’s OPO-specific reports (OSRs), originally scheduled for April 1, 2023, has been delayed. In order to reduce the potential confusion with the upcoming release of performance metric information by the Centers for Medicare and Medicaid Services (CMS), the upcoming OSRs are being revised and will not include information regarding CMS performance measures as previously planned.

SRTR will release the draft OSRs on the SRTR Secure Site as soon as programming changes are implemented. SRTR will announce a new release date as soon as possible. Any data corrections must still be made to OPTN data by April 30, 2023 as originally scheduled. This delay does not affect the release of the draft transplant program-specific reports (PSRs) scheduled for April 1, 2023. We apologize for any inconvenience caused by this scheduling adjustment. For more information, please contact us.

Posted: 3/31/2023

2021 Annual Data Report (ADR) Now Live

The 2021 Annual Data Report (ADR) is now live! The ADR provides national statistics and describes trends in donation and transplantation, and is produced by the Organ Procurement and Transplantation Network (OPTN) and the Scientific Registry of Transplant Recipients (SRTR). This thirty-first annual report is based on data pertaining to the period 2010-2021. It covers the most recent complete year of transplants, those performed in 2021. The ADR is accessible through srtr.transplant.hrsa.gov and is also available via the American Journal of Transplantation.

Posted: 3/2/2023

Upcoming Modifications to SRTR’s Organ Procurement Organization (OPO)-specific Reports

Pursuant to SRTR’s contract with the Health Resources and Services Administration (HRSA), SRTR will be modifying future releases of the OPO-specific Reports (OSRs) to include reporting of the new OPO performance metrics implemented by the Centers for Medicare and Medicaid Services (CMS) on August 1, 2022 (42 CFR Part 486). Beginning with the July 2023 release of the OSRs, SRTR is planning to include reporting of the Donation Rate and Transplant Rate as defined by CMS*. These metrics will be accompanied by detailed data tables along with presentations of the metrics. Future changes are being explored, including the potential to report the metrics within subgroups and with additional risk adjustment to provide deeper insights into the OPOs performance on these metrics.

In addition to adding the new CMS metrics, SRTR will no longer be reporting the Eligible Death Donation Rate beginning with the July 2023 release of the OSRs.

Both of the above changes were reviewed and approved by the SRTR Review Committee (SRC) at its meeting on February 3, 2023. All changes are pending programming. For more information, please contact us.

*While SRTR aims to reproduce the CMS metrics as defined, results may slightly differ from those presented in official CMS reports. This is due to differences in when underlying data were sourced or differences in how OPO mergers are handled within the reports. In the event of differences, CMS-released reports will remain the official evaluation for the purposes of OPO evaluation and recertification determinations.

Posted: 2/21/2023

Now Available: Fall 2022 PSRs/OSRs

Find the latest program-specific and OPO-specific reports on our website. In addition to the traditional PDF format, these reports are also available in our interactive, mobile-friendly format.

Stay up to date on PSR and OSR reporting timelines by visiting our website.

As of 1/1/2023, The Living Legacy Foundation of Maryland and Washington Regional Transplant Community have merged. OPO-specific reports (OSRs) will reflect this change beginning with the Spring 2023 OSRs (July, 2023).

Posted: 1/5/2023

Now Available: Spring 2022 PSRs/OSRs

Find the latest program-specific and OPO-specific reports on our website. In addition to the traditional PDF format, these reports are also available in our interactive, mobile-friendly format. The Donation and Transplantation Analytics (DATA) tool has also been updated with the most recent data cohort. If you have questions, don’t hesitate to contact us.

Stay up to date on PSR and OSR reporting timelines by visiting our website.

Posted: 7/6/2022

2020 Annual Data Report (ADR) Now Live

The 2020 Annual Data Report (ADR) is now live. The ADR provides national statistics and describes trends in donation and transplantation, and is produced by the Organ Procurement and Transplantation Network (OPTN) and the Scientific Registry of Transplant Recipients (SRTR). This thirtieth annual report is based on data pertaining to the period 2009-2020. It covers the most recent complete year of transplants, those performed in 2020. The ADR is accessible through srtr.transplant.hrsa.gov, and is also available at the American Journal of Transplantation.

Posted: 3/14/2022

New Donation and Transplantation Analytics (DATA) Tool Live

The Scientific Registry of Transplant Recipients (SRTR) has launched a new tool called Donation and Transplantation Analytics (DATA). This new transplant data query system enables users to view and analyze the most current transplant data available. The platform also facilitates the creation of custom, easily downloadable and shareable report graphics and tables for transplant candidates, recipients, and donors. The DATA tool is currently in beta; please contact SRTR with any questions or comments about the current version.

Posted: 1/12/2022

Now Available: Fall 2021 PSRs/OSRs

Find the latest program-specific and OPO-specific reports on our website. In addition to the traditional PDF format, these reports are also available in our interactive, mobile-friendly format.

Stay up to date on PSR and OSR reporting timelines by visiting our website.

COVID-19 Changes Associated with the January 2022 Program-specific and OPO-specific Reports

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 transplant system through publication of semiannual transplant program-specific reports (PSRs) and organ procurement organization (OPO)–specific reports (OSRs). These reports contain performance metrics covering various 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.

The SRTR Review Committee (SRC) has reviewed the impact of the pandemic on SRTR’s public reporting activities and has made recommendations on report modifications. The January 2021 reports were modified to exclude postpandemic data from all performance metrics as previously announced. The July 2021 reports made additional modifications to the reports on a measure-by measure basis as previously announced. On January 6, 2022, the semiannual reports were updated on the SRTR website with additional modifications to remove data from March 13, 2020, through June 12, 2020 (the “carve-out period”) as previously announced. These reports are the first to include patients who underwent transplants after the carve-out period. SRTR has worked with the SRC and its 3 subcommittees (the Analytical Methods Subcommittee, the Human-Centered Design Subcommittee, and the Patient and Family Affairs Subcommittee) to review and implement these changes.

Both SRTR and the SRC acknowledge the impact that the COVID-19 pandemic has had on the transplant system and the entire healthcare system. SRTR continues to actively monitor and discuss the effects of the pandemic with the SRC and has provided a COVID-19–evaluation application on the SRTR website. In consultation with HRSA and the SRC, SRTR continues to publish the PSRs and OSRs with the understanding that the pandemic may be affecting various performance metrics. Excess deaths due to COVID-19 have been noted during this reporting period and SRTR and the SRC acknowledge that the pandemic has affected different regions of the country at different times. Adjusting the outcomes metrics or assessing risk according to factors related to SARS-CoV-2 status in donors and recipients are possibilities that SRTR continues to discuss, but significant challenges remain.

SRTR will continue to work with the SRC and its subcommittees to evaluate optimal ways to provide information to the interested public as the nation’s transplant system strives to optimize patient outcomes through the gift of organ donation and transplantation.

Questions? Contact us.

Posted: 01/6/2022

Updated Liver Waiting List Calculator

The SRTR Liver Waiting List Calculator has received a massive refresh! Displaying a streamlined user interface and side-by-side comparisons of liver waitlist outcomes at the center and regional level, the most-used SRTR application has become much easier to navigate. The application also now has multiple print and digital export options.

The Liver Waiting List Calculator was created to help patients in need of a liver transplant, their families, and their doctors understand the experiences of patients on a liver transplant program's waiting list over the past two years. The tool takes a snapshot of each program's waiting list and then determines what happened to each candidate on that list over the following year, including at 30, 60, 90, 180, and 365 days. For more information about the application, visit the app’s documentation page.

If you have any questions about this update, please contact us.

Posted: 9/16/2021

Updated Lung Risk-adjustment Models

The lung risk-adjustment models for patient mortality after listing were updated on July 16, 2021, following initial release on July 6, 2021. Previously, the models included candidate pCO2 captured on the transplant candidate registration (TCR) form. This variable was removed in 2015 from the TCR form, but was kept in the risk-adjustment models resulting in a significant amount of missing values. As a result, the expected number of events for most lung patients was unrealistically low due to the least beneficial value adjustment for missing data.

Now, the lung risk-adjustment models no longer include the pCO2 variable captured on the TCR form, resulting in a better evaluation of patient mortality after listing for lung transplant candidates. This correction affects Figures B7 and B8.

Areas across our web environments where you will see this lung-only change reflected are:

Lung program-specific report PDFs.
Our new interactive reports for Lung, under Deceased Donor Transplant Rates, under the ‘Overall Survival From Listing’ tab.
National Center-level Summary Data for Lung (found at the bottom of the PSRs landing page.)
Lung Mortality After Listing Risk-adjustment Models.
Lung Mortality After Listing Expected Survival Worksheets on the SRTR Secure Site.

If you have any questions about this update, please contact us.

Posted: 7/16/2021

Now Available: Spring 2021 PSRs/OSRs

Find the latest program-specific and OPO-specific reports on our website. In addition to the traditional PDF format, these reports are also available in our new, interactive, mobile-friendly format. These reports also reflect COVID-19-related changes; learn more about these changes by reading the announcement we shared earlier this year. We also have an FAQs page dedicated to addressing community concerns. If you still have questions, don’t hesitate to contact us.

Stay up to date on PSR and OSR reporting timelines by visiting our website.

Posted: 7/6/2021

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.

For more information about these decisions, please refer to our FAQs. For questions and comments, please contact us.

Posted: 5/27/2021

COVID-19 Changes for July 2021 Reports: Upcoming Adjustments to Transplant Program and OPO Evaluation Metrics

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 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 survival and patient survival.

In response to the current global pandemic, SRTR modified the evaluation metrics for transplant programs and OPOs for the reports released in January 2021. The reports released in January 2021 made adjustments to transplant program and OPO performance metrics so that data beyond the declaration of a national public health emergency on March 13, 2020, were not included in the metrics.

The SRTR Review Committee (SRC) reviewed the metrics at its meetings on January 20, 2021, and February 9, 2021, with the goal of determining whether continued adjustments are necessary, or if the SRTR should resume regular reporting of transplant program and OPO performance metrics. The committee reviewed data on how the pandemic has affected the nation’s transplant system, and the extent to which the effects varied geographically and temporally. The committee made the following recommendations to SRTR. These recommendations were reviewed by the Health Resources and Services Administration’s (HRSA’s) Division of Transplantation, which oversees the SRTR. HRSA approved of these recommendations which the SRTR will implement for the July 2021 reporting cycle:

Posttransplant Outcomes (including 1-month, 1-year, and 3-year graft and patient survival): Evaluations cohorts will continue to exclude transplants and follow-up time beyond March 12, 2020.
- 1-month & 1-year Patient and Graft Survival Evaluations: Transplants 1/1/2018-3/12/2020; follow-up through 3/12/2020.
- 3-year Patient and Graft Survival Evaluations: Transplants 7/1/2015-12/31/2017; follow-up through 3/12/2020.
Waitlist Mortality Rate: Evaluations cohorts will be modified on an organ-specific basis:
- Kidney and Lung: Candidates on the waitlist 1/1/2019-3/12/2020.
- Liver, Heart, Pancreas, and Intestine: Candidates on the waitlist 1/1/2019-12/31/2020.
Transplant Rate: The first quarter following declaration of a national emergency will be excluded from the transplant rate evaluations for all organ types.
- Candidates on the waitlist 1/1/2019-3/12/2020 and 6/13/2020-12/31/2020.
Overall Rate of Mortality After Listing: Patient follow-up will continue to be truncated on 3/12/2020:
- Evaluation period: 1/1/2019-3/12/2020.
Offer Acceptance Rate: These evaluations will return to normal reporting cohorts.
- Offers received 1/1/2020-12/31/2020.
Eligible Death Conversion Rate: Eligible deaths during the first quarter of the national emergency will be excluded from evaluation.
- Eligible deaths 1/1/2020-3/12/2020 and 6/13/2020-12/31/2020.
Deceased Donor Organ Yield: Deceased donors during the first quarter of the national emergency will be excluded from evaluation.
- Deceased donors 1/1/2019-3/12/2020 and 6/13/2020-12/31/2020.

These decisions will apply to the evaluations released in the SRTR’s semi-annual program-specific reports scheduled for release on July 6, 2021. These changes have been communicated to the leadership of the Organ Procurement and Transplantation Network’s Membership and Professional Standards Committee (MSPC). These decisions will then be re-evaluated as more information becomes available in preparation for the release scheduled for January 2022.

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

For more information regarding these decisions, please refer to our FAQs. We wish all of you, our donation and transplant colleagues, the best in your continued efforts to heal and save lives through the gift of transplant during this challenging time. For questions and comments, please contact us.

Posted: 3/12/2021

The New SRTR Review Committee

The SRTR Review Committee (SRC), formerly known as the SRTR Visiting Committee (SVC), provides objective expert review of SRTR contract activity, including methodological and analytical activity, websites, tools, and simulation modeling. In addition, the SRC exists to advise the Board of Directors of the Organ Procurement and Transplantation Network (OPTN) and OPTN committees.

Since the beginning of the new SRTR contract awarded by HRSA in September of 2020, the new SRC has undergone significant enhancements to provide even better expert guidance to the SRTR. In addition to the main SRC, three standing subcommittees have been formed: the Analytic Methods Subcommittee (provides objective review and advice to SRTR contract activity as it relates to analytical methods, simulation modeling, and operations research), the Patient and Family Affairs Subcommittee (provides objective review and advice to SRTR contract activity as it relates to providing information to patients and families), and the Human-Centered Design Subcommittee (provides objective review and advice to SRTR contract activity as it relates to providing information to various stakeholders, including patients and families, transplant professionals, and the general public.)

Joining the main SRC in 2021 are:

Co-chair: Roslyn Mannon, MD, Transplant Nephrologist, University of Nebraska Medical Center, Omaha, NE

Members:

Kiran Khush, MD, MAS, Transplant Cardiologist, Stanford University Medical Center, Stanford, CA
Christopher Zinner, Managing Director, Accenture Federal Services

Ex-Officio Member (Chair of the OPTN Data Advisory Committee): Rachel Patzer, PhD, MPH, Director, Transplant Health Services and Outcomes Research Program, Emory University School of Medicine, Atlanta, GA

Joining the SRC subcommittees in 2021 are:

Analytic Methods Subcommittee:

Co-chairs: Brent Logan, PhD and Andrew Wey, PhD

Members:

Katherine Panageas, DrPH, Associate Attending Biostatistician, Memorial Sloan Kettering Cancer Center
Andrew Schaefer, PhD, Noah Harding Chair and Professor of Computational and Applied Mathematics, Rice University
David Vock, PhD, Associate Professor, Division of Biostatistics, School of Public Health, University of Minnesota
Shu-Xia Li, PhD, Associate Director of Data Management and Analytics at Yale-New Haven Hospital

Patient and Family Affairs Subcommittee:

Co-chairs: Allyson Hart, MD, MS and Richard Knight, MBA

Members:

Katie McKee, Living Donor
David Rodriguez, Kidney Recipient
Dale Rogers, Kidney Recipient
Rolanda Schmidt, PhD, Truth with Grace Consulting, Deceased Donor Family Member
Amy Silverstein, Heart Recipient
Carla Smith, Lung Recipient
Ameen Tabatabai, Liver Recipient

Human-Centered Design Subcommittee:

Co-chairs: Cory Schaffhausen, PhD and Christopher Zinner, Managing Director, Accenture Federal Services

Members:

Ryan Armbruster, MHA, Sr. Fellow, Division of Health Policy and Management
Sue Chu, PhD, Associate Dean for Academic Affairs, College of Design, University of Minnesota
Kate Clayton, Design Lead, Health, Fjord Design at Accenture Federal Services
Harry Hochheiser, PhD, Associate Professor Clinical and Translational Science

Posted: 2/11/2021

Now Available: Fall 2020 PSRs/OSRs

Stay up to date on PSR and OSR reporting timelines by visiting our website.

Posted: 1/5/2021

HHRI Awarded Continuation of SRTR Contract

Minneapolis, MN (September 21, 2020) – Following a federal open competition acquisition process, the Chronic Disease Research Group (CDRG) of the Hennepin Healthcare Research Institute (HHRI) was awarded the federal contract to operate the Scientific Registry of Transplant Recipients (SRTR). Among its key functions, the SRTR evaluates the status of the nation’s solid organ transplant system and provides analytic support to the Organ Procurement and Transplantation Network (OPTN) for purposes including the formulation and evaluation of organ allocation policies in the United States.

HHRI will continue to manage the SRTR under contract with the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). The new contract award marks the third contract term for the operation of the SRTR for HHRI, which has operated the SRTR since 2010. The new contract contains a series of optional terms that may extend the period of performance through September 2025.

HHRI is the research arm and a nonprofit subsidiary of Hennepin Healthcare System, Inc., an integrated healthcare system that includes the Hennepin County Medical Center (HCMC), a nationally recognized Level 1 Trauma Center and acute care and teaching hospital in Minneapolis, MN. HHRI is one of the largest nonprofit medical research institutions in Minnesota, ranking nationally in the top 10% of institutions receiving funding from the National Institutes of Health (NIH).

CDRG currently serves as the Coordinating Center for the United States Renal Data System (USRDS) and in the past has managed the Kidney Early Evaluation Program of the National Kidney Foundation (NKF), the North Central Donor Exchange Cooperative (a collaboration between kidney transplant centers in the Upper Midwest), the Peer Kidney Care Initiative, and the CKD (Chronic Kidney Disease) Health Evaluation Risk Information Sharing project conducted by NKF in collaboration with the Centers for Disease Control and Prevention (CDC). CDRG has also received international recognition for its analyses of chronic disease states, including chronic kidney disease, cardiovascular disease, and diabetes.

Jon J. Snyder, PhD, MS, will continue to serve as SRTR Director, Ajay K. Israni, MD, MS, as Deputy Director/Medical Director, Bertram L. Kasiske, MD, FACP, as Medical Director for Living Donation, and Ryutaro (Ryo) Hirose, MD, as Surgical Director. National Senior Staff members with organ-specific expertise and expertise in epidemiology, histocompatibility, biostatistics, economics, and computer modeling of allocation systems help complete the team. More information about SRTR can be found at www.srtr.org.

Posted: 9/21/2020

New Interactive Program- and OPO-specific Reports

SRTR is excited to announce the launch of our new, interactive, mobile-friendly program-specific reports (PSRs) and organ procurement organization-specific reports (OSRs). The PSRs and OSRs contain a vast amount of information that has historically been presented in PDF format, often containing more than 50 pages of information. This new presentation (available through a regular transplant program search on our website, titled New Interactive Report), marks a new milestone in the evolution of these reports by converting the information in the PDFs into modern, mobile-friendly, interactive data visualizations. These visualizations allow users to quickly navigate the information, download the data and figures, and share this information with colleagues and patients as needed. We hope this momentous update to the reports is helpful and furthers the work we do in the nation’s donation and transplantation community. If you have any questions about this update, please contact us.

Posted: 9/16/2020

Now Live: COVID-19 Evaluation App

The first version of the COVID-19 evaluation application is now live on the SRTR public website. The application presents the differences in waitlist outcomes, offer acceptance, posttransplant graft survival, and donor utilization before and after the emergence of COVID-19. The evaluation includes a wide range of descriptive statistics and adjusted analyses, including the effect of COVID-19 on patient subgroups (eg, candidate age). This app will have periodic updates, so stay tuned to our website and social media platforms for the announcements. If you have any questions about the current version of the app, please contact us.

Posted 9/9/2020

Now Live: Acuity Circles Evaluation App

An application that evaluates acuity circles’ impact on liver transplantation is now live on the SRTR public website. The application investigates changes in waitlist outcomes, donor utilization, and transplant characteristics before and after the implementation of acuity circles. SRTR plans to update the application monthly as more information becomes available.

Posted: 8/11/2020

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

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 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 survival and patient survival.

In light of the current global pandemic, SRTR will be modifying the evaluation metrics for transplant programs and OPOs. 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, ie, 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, eg, waitlist counts, transplant counts, recipient characteristics, donor counts, donor characteristics, etc., but will exclude data from performance evaluation metrics, eg, 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. We emphasize that the Visiting Committee and HRSA will continue to evaluate this solution to determine future changes as the pandemic continues to evolve and SRTR can investigate alternative solutions.

We wish all of you, our donation and transplant colleagues, the best in your continued efforts to heal and save lives through the gift of transplant during this challenging time. For questions and comments, please contact us.

Posted: 8/6/2020

Now Available: Spring 2020 PSRs/OSRs

Find the latest program-specific and OPO-specific reports on our website.

Patient Mortality after Listing is now part of the public PSR and was incorporated as Table B6. Therefore the former Table B6 and all B tables below that have also shifted down one numeral. For instance, the former Table B9 Time to Transplant for Waiting List Candidates, is now Table B10. The methodology has also been updated to reflect this change.

Stay up to date on PSR and OSR reporting timelines.

Posted: 8/4/2020

Spring 2020 Data Review Period Extended

In light of the COVID-19 pandemic, SRTR is extending the Data Review Period deadline from April 30 to May 31. This allows transplant programs and OPOs more time to review their data for accuracy during this difficult time. Given the rapidly evolving situation, the deadline may be extended again in the future, and SRTR will work closely with HRSA and OPTN leadership to make that determination. Data Integrity Reports and program-specific report drafts for transplant programs and Donor Level Data sheets and OPO-specific report drafts for OPOs are available to review from April 1-May 31, until 11:59 PM EDT. Verify data and make changes in UNet or DonorNet. The SRTR Visiting Committee will be reviewing the situation and making a recommendation to HRSA regarding suggested modifications to the performance metrics contained in the program-specific and OPO-specific reports. SRTR will also keep the community informed of the eventual public release dates for this round of the reports.

If you have questions and/or comments, please contact us.

Posted: 4/1/2020

SRTR Tools 101: Helpful tools for transplant programs on the SRTR websites

This webinar discusses helpful tools available to transplant programs on the SRTR public and secure websites. Tools include the Liver Waitlist Calculator, the Kidney Transplant Decision Tool, the Pretransplant Survival Worksheets, and the Posttransplant expected Survival Worksheets.

Date: Wednesday, May 6, from 1-2 p.m. CDT

Register

Posted: 3/2/2020

Now Available: Fall 2019 PSRs/OSRs

Find the latest program-specific and OPO-specific reports on our website. In this release, age and body mass index (BMI) categories have expanded. Table categories include ages 65-69 and 70+, and BMI has expanded to include 31-35, 36-40, and 41+.

An adjustment for biopsy results has also been added in posttransplant models for kidney and liver, and in kidney and liver OPO yield models.

Additionally, posttransplant intestine and survival from listing models are being previewed with this release.

Stay up to date on PSR and OSR reporting timelines by visiting our website.

Posted: 1/7/2020

Dr. Ryutaro Hirose to Join SRTR as Surgical Director

The Scientific Registry of Transplant Recipients (SRTR) is pleased to announce the addition of Dr. Ryutaro (Ryo) Hirose as Surgical Director of the SRTR. Dr. Hirose serves as Professor of Clinical Surgery at the University of California, San Francisco (UCSF) and will continue in that role while lending his vast expertise to SRTR. In this new role, Dr. Hirose will provide general surgical expertise to all aspects of SRTR, support the OPTN Board of Directors and committees, and will serve as primary surgical liaison to professional societies, including the American Society of Transplant Surgeons (ASTS). Dr. Hirose received his MD from Columbia University College of Physicians and Surgeons and completed his residency, postdoctoral fellowship, chief residency, and fellowship all at UCSF. Dr. Hirose has served on various committees within the ASTS, and has served as vice-chair and chair of the Liver and Intestinal Transplantation Committee of the Organ Procurement and Transplantation Network (OPTN). Dr. Hirose will join the leadership team comprised of Dr. Ajay Israni, SRTR Medical Director and Deputy Director, Dr. Bertram Kasiske, SRTR Medical Director for Living Donation, and Dr. Jon Snyder, SRTR Director. SRTR looks forward to continued service to the Health Resources and Services Administration (HRSA) with Dr. Hirose’s leadership.

For questions and comments, contact us.

Posted: 11/19/19

SRTR Leadership Change

Effective September 21, 2019, Bertram Kasiske, MD, FACP, will be stepping down as the Director of the Scientific Registry of Transplant Recipients (SRTR), and Jon Snyder, PhD, will assume the Director role. Dr. Kasiske has been the Director since September of 2010 and has lead SRTR through 9 successful years, overseeing improvements in program-specific and OPO-specific reporting, creation of new public and secure SRTR websites, the launch of the Living Donor Collective pilot project, publication of the SRTR/OPTN Annual Data Reports, support of all OPTN policymaking committees, and numerous scientific publications furthering the field of solid organ transplantation.

Dr. Kasiske will continue supporting SRTR with a primary focus on living donation, continuing to lead the Living Donor Collective pilot project, and Ajay Israni, MD, MS, will continue to serve as the Deputy Director of SRTR.

Dr. Snyder has been the Director of Transplant Epidemiology for SRTR since September 2010, and he began his career in the field of transplant epidemiology in 1999. He oversees the Chronic Disease Research Group’s (CDRG) research in the areas of organ, eye, and tissue donation and transplantation. CDRG currently operates SRTR under contract with the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services. Dr. Snyder’s research focuses on data analytics targeted at healing and saving lives through transplantation. In addition to his work with SRTR, Dr. Snyder serves as a Statistical Editor for the American Journal of Transplantation and as an Associate Editor for the journal Transplantation. He also serves on the Board of Directors for Donate Life America and the Organ Donation and Transplantation Alliance. Dr. Snyder holds a Master of Science in Biostatistics and a Doctor of Philosophy in Epidemiology from the University of Minnesota, where he also holds an adjunct faculty appointment in the Division of Epidemiology and Community Health, School of Public Health.

Continuing to provide excellent service to HRSA and the transplant community will remain Dr. Snyder’s primary focus as the Director of SRTR. Questions and/or comments can be directed to srtr@srtr.org.

Posted: 8/15/19

Now Available: Spring 2019 PSRs/OSRs

Find the latest program-specific and OPO-specific reports on our website. Stay up to date on PSR and OSR reporting timelines.

Posted: 7/8/2019

Now Available: Transplant Rate, Waitlist Mortality, and Offer Acceptance Model Previews for Pancreas and Intestine Transplant

The Scientific Registry of Transplant Recipients (SRTR) has updated the transplant rate and waitlist mortality models used in the program-specific reports (PSRs) for pancreas and intestine programs. Additionally, a new offer acceptance model was developed for pancreas and kidney-pancreas transplantation. The models will be integrated into the July 2019 PSRs. Offer acceptance CUSUM charts for pancreas and kidney-pancreas programs will be available on the SRTR secure site after the release of the PSRs.

Similar to last year’s update of the kidney, liver, lung, and heart models, the updated transplant rate and waitlist mortality models changed in three significant ways

A much wider range of candidate characteristics at listing are considered, including information from the status history and/or justification files.
Updated models use a single 2-year cohort rather than two separate 1-year cohorts.
Models are now estimated with the least absolute shrinkage and selection operator (LASSO). The LASSO can select important covariates while improving the predictive performance of the models.

A preview of the updated transplant rate and waitlist mortality models is available on our website, and a separate preview of the new offer acceptance models for pancreas and kidney-pancreas transplant is also available. The transplant rate and waitlist mortality models were built using a similar process to the posttransplant models. For more information, read the SRTR publication Developing Statistical Models to Assess Transplant Outcomes Using National Registries: The Process in the United States.

Share your feedback on the transplant rate and waitlist mortality models by contacting us.

Posted: 3/4/2019

Improved SRTR Website Launched February 5, 2019

The 5-tier outcome assessment system is live on the SRTR public site. Please read our previous announcement about the planned move. Contact us with any questions or comments at srtr@srtr.org.

Posted: 2/5/2019

5-Tier System Moving from Beta Site to Public Site

After applying multiple improvements based on feedback received, SRTR also recently called for public comment on the beta site changes and collected additional feedback for a period of 60 days (May 14, 2018 to July 13, 2018). Changes were made in response to the feedback received, and SRTR is pleased to announce that after receiving both HRSA and SVC approval, the 5-tier outcome assessment system will be moving from the beta site to the public site on February 5, 2019.

In response to the feedback and SVC’s recommendations, changes made include:

Five-tier assessments for waitlist mortality and deceased donor transplant rate have been added, in response to feedback that the new system placed too much emphasis on first-year transplant outcomes. Additional feedback received advocated not to provide a waitlist mortality tier for kidney candidates because kidney programs do not care for candidates as directly as other organ types, so SRTR removed the waitlist mortality tier for kidney programs.
The transplant rate is now based on deceased donor transplants only, rather than on both deceased and living donor transplants, in response to feedback that the combined transplant rate was potentially misleading to patients without a living donor.
Living donor transplant counts for liver and kidney programs are now displayed alongside the deceased donor transplant counts, in response to feedback that the site should prominently display programs that perform more living donor transplants.
Various improvements to educational materials provided alongside the search results have been made, including 1) improved explanatory text for each outcome as determined through patient focus groups; 2) a key that shows expected outcomes for programs in each tier for waitlist mortality, transplant rate, and first-year graft survival; 3) an indicator showing which outcome has the greatest overall impact on survival after listing for each organ; 4) removal of interpretive text previously provided with each tier, eg, “worse than expected,” “better than expected.”

You can currently view detailed information about these updates/changes on this beta site, and the 5-tier system will soon become available on the public website. These changes were made following feedback received from the community and vetted through patient focus groups and randomized trials of various website iterations during 2017 and 2018. SRTR continues to welcome feedback and is always looking for ways to improve the program assessments in place. Contact us with any questions or comments at srtr@srtr.org.

Posted: 1/16/2019

2017 ADR Delay

The 2017 Annual Data Report (ADR) release will be delayed at this time. The delay is due to the Organ Procurement and Transplantation Network (OPTN) experiencing an unanticipated loss of its source for supplemental information identifying whether a patient is currently living or deceased. This death data loss occurred last Spring.

The anticipated publication date is not available at this time, but we will alert the public as soon as a date is available. Stay tuned to our website and social media platforms for more information on this matter as it develops. If you have any questions, please contact us at srtr@srtr.org.

Posted: 1/10/2019

Now Available: Fall 2018 PSRs/OSRs

Find the latest program-specific and OPO-specific reports on our website. Stay up to date on PSR and OSR reporting timelines

Posted: 1/7/2019

Now Available on the SRTR Website: the Delayed Spring 2018 PSRs

SRTR’s program-specific reports (PSRs) originally scheduled to be released in July 2018 are now available on the SRTR website. The transplant community should be aware of three important changes incorporated into these reports:

Adult and pediatric definitions have been updated for pre- and posttransplant metrics presented in the reports. The patient’s age at the time of registration on the waiting list is now used throughout to classify pediatric (listed before their 18th birthday) and adult patients.
SRTR previously did not attempt to build risk adjustment models for posttransplant outcomes if fewer than 25 events occurred within the 2.5-year transplant cohort. This resulted in some subsets of transplant recipients having no evaluation presented in the reports. SRTR is now providing unadjusted evaluations in these instances rather than providing no evaluation at all.
The delay in the release of these reports was due to a temporary loss of access to additional death information. These reports may contain additional deaths that were not known at the time of the data review period in April 2018.

Stay up to date on PSR reporting timelines. If you have any questions, please contact us at srtr@srtr.org.

Posted: 10/9/2018

Spring 2018 PSRs Upcoming Release

The delayed spring 2018 program-specific reports (PSRs) will be released according to the following timeline: the secure preview on the SRTR secure site will occur on 9.13.2018, and the public release will occur on 10.9.2018.

The January 2019 PSRs will be released according to the regular schedule; the data review period will occur in October 2018; the secure preview will be released on 12.17.2018, and the public release will occur on 1.7.2019.

The PSR delay was due to the Organ Procurement and Transplantation Network (OPTN) experiencing an unanticipated loss of its source for supplemental information identifying whether a patient is currently living or deceased. After confirmation of a large volume of data, all patient status information has been updated and incorporated into the OPTN database.

If you have any questions, please contact us at srtr@srtr.org.

Posted: 8/16/2018

SVC Meeting Beta Site Update

On July 16, 2018, The SRTR Visiting Committee (SVC) discussed the beta site feedback received during the 60-day comment period. Over the next two months, SRTR will further evaluate the feedback, and at the next SVC meeting (September 11, 2018), a decision will be made regarding the path forward for the 5-tier outcome assessment system, which continues to be available for review on the beta site.

The updated beta site currently reflects changes made following previously received feedback from the community; feedback that was vetted through patient focus groups and randomized trials of various website iterations during 2017 and early 2018. SRTR continues to welcome feedback regarding these changes as we evaluate the most recent feedback. Stay tuned to our website and social media platforms for the latest developments regarding the beta site, and contact us with any questions or comments at srtr@srtr.org.

Posted: 7/17/2018

Spring 2018 OSRs Upcoming Release, PSRs Delay

The spring 2018 OPO-specific reports (OSRs) will be released according to our previously anticipated timeline. The secure preview will occur on 7.16.2018, and the public release will occur on 8.9.2018. However, the release of the program-specific reports (PSRs) is postponed at this time. This delay is due to the Organ Procurement and Transplantation Network (OPTN) experiencing an unanticipated loss of its source for supplemental information identifying whether a patient is currently living or deceased. In April 2018, OPTN began receiving this information again, and is in the process of confirming a large volume of data. All patient status information that is ultimately confirmed will then be incorporated into the OPTN database and will be used in OPTN and SRTR data analyses and reporting, including the PSRs.

As soon as the updated information becomes available, we will announce the PSR release timeline. At that time, we will also offer updated SAFs for researchers who received a SAF release from September 2017, December 2017, March 2018, or June 2018.

This missing information also potentially affects the 2017 Annual Data Report (ADR) development. The anticipated publication date is not available at this time, but we will alert the public as soon as a date is available.

Stay tuned to our website and social media platforms for more information on this matter as it develops. If you have any questions, please contact us at srtr@srtr.org.

Posted: 7/9/2018

Spring 2018 PSRs & OSRs Delayed

The spring 2018 release of program-specific and OPO-specific reports (PSRs and OSRs) will be delayed. The Organ Procurement Transplantation Network (OPTN) experienced an unanticipated loss of its source for supplemental information identifying whether a patient is currently living or deceased. This information is important in transplant outcomes analysis.

In April 2018, OPTN began receiving this supplemental information again, and is in the process of confirming a large volume of information. All patient status information that is ultimately confirmed will then be incorporated into the OPTN database and will be used in OPTN and SRTR data analyses and reporting, including the PSRs and OSRs.

Due to the delay, the spring 2018 PSRs/OSRs will not be released on their scheduled date (7.9.2018). Instead, the anticipated release will be delayed until 8.9.2018. This delay will also apply to the secure preview; instead of 6.15.2018, the secure release is anticipated to be previewed on 7.16.2018.

As soon as the updated information becomes available, data updates will be implemented. At that time, we will also be offering updated SAFs for researchers who received one of the following SAF releases: September 2017, December 2017, or March 2018.

Thank you for your patience as we work with our partners to resolve this issue. If you have any questions, please contact us at srtr@srtr.org.

Posted: 5/24/2018

Updated Beta Site Live for Review

In December 2016, SRTR launched a new website that displayed a new 5-tier outcome assessment for all transplant programs in the United States. This new system, which replaced a 3-tier system, was developed over a period of 5 years and approved by SRTR’s Visiting Committee (SVC). In response to community feedback, the 5-tier system was moved to a Beta website in February 2017, and was replaced by the previous 3-tier system on the main SRTR website. The intent of the Beta site was to allow for more feedback and to consider additional improvements. Changes have been made in response to the feedback received, and SRTR is pleased to announce that an updated version of the Beta website has been launched. SRTR will seek feedback for a period of 60 days ending July 13, 2018, after which the SVC will recommend further modification or moving the Beta site to the main SRTR website.

Changes to the site include:

Five-tier assessments for waitlist mortality and deceased donor transplant rate have been added, in response to feedback that the new system placed too much emphasis on first-year transplant outcomes.
The transplant rate is now based on deceased donor transplants only, rather than on both deceased and living donor transplants, in response to feedback that the combined transplant rate was potentially misleading to patients without a living donor.
Living donor transplant counts for liver and kidney programs are now displayed alongside the deceased donor transplant counts, in response to feedback that the site should prominently display programs that perform more living donor transplants.
Various improvements to educational materials provided alongside the search results have been made, including 1) improved explanatory text for each outcome as determined through patient focus groups; 2) a key that shows expected outcomes for programs in each tier for waitlist mortality, transplant rate, and first-year graft survival; 3) an indicator showing which outcome has the greatest overall impact on survival after listing for each organ; 4) removal of interpretive text previously provided with each tier, eg, “worse than expected,” “better than expected.”

These changes were made following feedback received from the community and vetted through patient focus groups and randomized trials of various website iterations during 2017 and early 2018. SRTR welcomes feedback regarding these changes, and will collect feedback for a period of 60 days, at which time the Visiting Committee will consider the feedback and recommend any changes.

Feedback can be provided to srtr@srtr.org. We’ll also be available at the 2018 American Transplant Congress (ATC) meeting (June 2-6), booth #202, and at the 2018 AOPO Annual Meeting (June 18-21), booth #409, to answer any questions. Review the current version of the beta site at beta.srtr.org.

Posted: 5/14/2018

Coming Soon: 5-Tier Outcome Assessment Update

In approximately two weeks, a new version of the SRTR beta site will be available for review and comment. A beta version of the SRTR website containing the 5-tier outcome assessment has been available online over the past year. During that time, SRTR has worked with HRSA and the SRTR Visiting Committee (SVC) to consider feedback. Transplant professionals, researchers, and patients and their family members submitted comments. SRTR has been working with HRSA and the SVC to implement a series of changes in response to feedback received. Additionally, Drs. Ajay Israni and Cory Schaffhausen have been conducting research funded by the Agency for Healthcare Research and Quality (AHRQ) to study how patients use and interpret the information on the SRTR website. Their research has also led to a number of suggested improvements in the presentation of the data for public consumption.

With HRSA and the SVC’s guidance, a new version of the beta website has been developed. The new version presents a number of improvements, including 5-tier assessments of waitlist mortality and deceased-donor transplant rate, in addition to posttransplant outcomes, indicators of which metrics have the most overall impact on patient survival following listing, and improved language and educational material. SRTR will launch the updated beta site for a 60-day comment and review period. This update to the beta site is expected to go live by mid-May.

We’ll be available at the 2018 American Transplant Congress (ATC) meeting (June 2-6), booth #202, to answer any questions. Review the current version of the beta site at beta.srtr.org.

Posted: 5/3/2018

Live: Living Donor Collective Website

The Living Donor Collective (LDC), a pilot project with 16 transplant programs (10 kidney and 6 liver) following long-term health outcomes after living organ donation, has launched a website that houses information about the initiative. The Scientific Registry of Transplant Recipients (SRTR), under contract with the Health Resources and Services Administration (HRSA) will be conducting this pilot initiative over the next two years, with the intent of ultimately including all donors and potential donors in the US once the pilot phase is complete. Data collection for the pilot phase will begin in April 2018. You can access the website at www.livingdonorcollective.org for more information about the project.

The purpose of the LDC is to study the long-term health and wellbeing of living kidney and liver donors. Transplant programs will register all persons being evaluated at their center. Donors can then be compared to individuals that were evaluated for donation but did not donate, to understand the effect of donating. In time, we will be able to tell persons considering donating about the long-term benefits and risks of living donation.

If you have any questions about the Living Donor Collective, please contact us.

Posted: 3/13/2018

SRTR to Host Webinar on Offer Acceptance

The Scientific Registry of Transplant Recipients (SRTR) began publicly reporting new offer acceptance metrics for heart, kidney, liver, and lung programs in 2017. These metrics are designed to provide programs with data about their acceptance patterns within various subgroups of offers, and allows programs to benchmark against other programs nationally. In addition, SRTR began providing CUSUM charts for offer acceptance on SRTR's secure website. The goal of this webinar is to describe the new metrics, the methodologies used to derive the metrics, and to provide insights into interpreting and using the metrics. Space is limited, pre-register for the event today:

Date/Time: Wednesday, March 14, 2018, 1 – 2 p.m. CST.

Link: https://goo.gl/7h5D76

Posted: 2/6/2018

January 2018 Program-Specific and OPO-Specific Reports (PSRs and OSRs) Now Available on SRTR Public, Beta, and Secure Sites

The January 2018 PSRs/OSRs now reflect new posttransplant liver risk adjustment models, new waitlist transplant and mortality rate models, expanded offer acceptance reports, and updated organ yield models. For an in-depth look at these improvements, visit our news page to read our previous announcements about these updates.

For offer acceptance reports, SRTR has integrated liver, heart, and lung offer acceptance metrics into the PSRs. In addition to the offer acceptance metrics provided in the public reports, SRTR is providing offer acceptance CUSUM charts along with a national summary report on the SRTR secure site*. The national summary report is also provided to the OPOs.

Additionally, waitlist transplant and mortality rate models now report on 2-year cohorts rather than 1-year cohorts.

Transplant programs and OPOs can log onto the SRTR Secure Site to view the PSRs/OSRs January 2018 release. The reports are also now available on the SRTR public & beta sites. Stay up to date on PSR and OSR reporting timelines by visiting srtr.org.

* Secure site access is only available to transplant program and OPO staff.

Posted: 1/5/2017

Program-Specific and OPO-Specific Reports Now Available on SRTR Secure Site.

Log onto the SRTR secure site to view reports. Reports will be available on the public and beta sites early January 2018.

Posted: 12/15/2017

New, Improved Transplant Rate, and Waitlist Mortality Models

SRTR has updated the transplant rate and waitlist mortality models for the program-specific reports (PSRs) of kidney, liver, lung, and heart programs. The models will be used to derive the expected number of transplants and deaths on the waiting list in the January 2018 PSRs.

There are several important characteristics of the updated models. First, a much wider range of candidate characteristics at listing are considered, including information from the status history and/or justification files. Second, inactive status was removed from the liver/heart models, due to concerns that this would create potential non-clinical incentives to inactive candidates unlikely to undergo transplant. Third, separate models are estimated for pediatric and adult candidates at listing. Additionally, the updated models use a single 2-year cohort rather than two separate 1-year cohorts. Lastly, the models are now estimated with the Least Absolute Shrinkage and Selection Operator (LASSO). The LASSO can select important covariates while improving the predictive performance of the models.

Pediatric candidates currently receive significantly more priority in allocation than adult candidates. Thus, beginning with the January 2018 PSR release, the transplant rate and waitlist mortality sections of the PSR will classify the observed and expected transplants and deaths on the waiting list by pediatric and adult status.

The updated transplant rate and waitlist mortality models can be previewed on our website. The models were built using a similar process to the posttransplant models; read the SRTR publication Developing Statistical Models to Assess Transplant Outcomes Using National Registries: The Process in the United States for more information.

Share your feedback on the transplant rate and waitlist mortality models by contacting us.

Posted: 10/2/2017

Offer Acceptance for Liver, Heart, and Lung Programs, and New Posttransplant Outcomes Models for Liver Programs

To identify the organ utilization practices of transplant programs, SRTR is working toward including program-specific offer acceptance practices in the program-specific reports (PSRs). Kidney offer acceptance was integrated into the PSRs in July 2017. Since then, SRTR has developed liver, heart and lung offer acceptance models and plans to integrate offer acceptance reports for these organs into the January 2018 PSRs. The models are being previewed on our website.

SRTR has also developed new liver posttransplant models for graft and patient survival, and plans to integrate these models into the January 2018 PSRs. These models are the first liver models to use the penalized modeling framework (LASSO) that has previously been applied to kidney, heart, and lung posttransplant models. This modeling framework allows SRTR to consider a large number of potential predictors without overfitting.

The new liver models also change how missing data is handled. Like the kidney, heart, and lung posttransplant models, when the models are fit, missing data is handled through multiple imputation. In multiple imputation, the non-missing data is used to predict the values of the missing data multiple times, producing multiple similar – but not identical – data sets with all of the missing data replaced with predicted values. The fitted coefficient values are then averaged across the different models.

Although multiple imputation works well for fitting the models, it can't be used for program evaluations. To encourage programs to submit data completely, SRTR calculates the lowest risk associated with the non-missing values of each predictor, then assigns that lowest-risk value to the missing data effect. Since missing data is treated as equivalent to the lowest-risk data, there is no incentive for programs to leave data elements missing.

The new liver models can be previewed here. More detailed information about the modeling process can be found in the following publication: Snyder JJ, Salkowski N, Kim SJ, Zaun D, Xiong H, Israni AK, Kasiske BL. Developing statistical models to assess transplant outcomes using national registries: The process in the United States Transplantation. 2016;100:288-294.

Comments on the offer acceptance and liver models can be submitted to srtr@srtr.org.

Posted: 9/18/2017

Organ Yield Models Updated

SRTR has updated the organ procurement organization (OPO) yield models and plans to integrate the models into the January 2018 OPO-specific reports (OSRs). These models are used to derive expected organ yield for deceased donors as reported in the OSRs.

As part of the process for updating the models, SRTR sought feedback on potentially important predictors and interactions among predictors; the responses directly contributed to incorporation of new predictors, for example, warm ischemia time for donation after circulatory death donors and ejection fraction. The models are now estimated with the Least Absolute Shrinkage and Selection Operator (LASSO). The LASSO can select important covariates while improving the prediction of organ yield. Additionally, in response to the HIV Organ Policy Equity Act, the updated models now adjust for donor HIV status.

The updated OPO yield models are currently being previewed on the SRTR website. Contact SRTR with any questions.

Posted: 8/24/2017

July 25 SVC Meeting: Public and Beta Websites Update

The SRTR Visiting Committee (SVC) met in person on July 25, 2017, primarily to discuss continued improvements to the transplant program data SRTR displays when website users search. When the SVC met on May 25, 2017, three recommendations were made to improve the search results:

Add a tier system for transplant rate and waitlist mortality rate to add context to program outcomes both pre- and posttransplant.
Make the transplant rate calculation based on transplants from deceased donors for kidney and liver programs, rather than including living donor transplants in the numerator of the calculation.
Split the transplant volume metrics into deceased and living donor transplants for kidney and liver programs.

Between the May and July meetings, SRTR staff worked to implement a version of the website that contains each of these recommendations. The results were reviewed by the SVC at the July meeting, and the following recommendations were made:

Inclusion of waitlist mortality on the search results page: The committee was supportive of including a tier system for waitlist mortality for all programs other than kidney. The SVC’s recommendation was to continue finalizing the models used to support the waitlist mortality evaluations and tier system for all organs, while seeking additional input from patients as to whether including waitlist mortality metrics in the primary search results would be beneficial.

Inclusion of a deceased donor transplant rate on the search results page: The committee was supportive of including the transplant rate tier based on deceased donor transplants along with the tiers for first-year survival.

Splitting transplant volume into deceased and living donor transplants: The committee reviewed a development version of the website that split transplant volume by deceased and living donor transplants for liver and kidney programs, and the members were supportive of this change.

In summary, the SVC continued to be supportive of adding pretransplant metrics to the search results page of the SRTR website to add context to post-transplant outcomes. The committee also recommended continuing to develop a waitlist mortality tier and a deceased donor transplant rate tier, with the caveat that more work is needed to understand whether a waitlist mortality tier is helpful to transplant patients. Additionally, the committee was supportive of splitting the transplant volume by deceased donor and living donor for kidney and liver programs, and SRTR will continue developing models to support a 5-tier system for transplant rate and waitlist mortality. If the SVC suggests moving forward with the tier system for the metrics currently being developed and tested, the system will first be previewed to the transplant community on the beta website (beta.srtr.org), seeking feedback for a period of 60 days.

Posted: 8/4/2017

Now Available on SRTR Public, Beta & Secure Sites: Spring 2017 Program-Specific Reports and OPO-Specific Reports

SRTR has integrated kidney offer acceptance behavior and multi-organ transplant information into the program-specific reports. The multi-organ tables provide descriptive information on multi-organ transplants performed by the program. Specifically, the tables present the number of completed multi-organ transplants, program-specific and national graft failure rates involving the component organs, and program-specific and national patient death rates.

The kidney offer acceptance tables and figures have three broad goals: provide general offer acceptance information in the public PSRs, give detailed information to programs and CUSUM reports on the secure site*, and communicate kidney offer acceptance information to organ procurement organizations (OPOs) through the secure site.

Log into the SRTR Secure Site to view the Spring 2017 release. PSRs and OSRs are also now available on the SRTR public & beta sites. Stay up to date on PSR and OSR reporting timelines by visiting srtr.org.

* Secure site access is only available to transplant program and OPO administrators.

Posted: 7/6/2017

Post-SVC Meeting Announcement: The Path Moving Forward

On May 9, 2017, the SRTR Visiting Committee held its quarterly meeting in Arlington, Virginia. In an attempt to seek better understanding of patient public website usage and needs, much of the 6-hour meeting was spent reviewing the feedback received regarding SRTR’s new 5-tier outcome assessment, with the goal of recommending a future direction for HRSA and SRTR. The committee recommended keeping the 3-tier system on the main SRTR website (www.srtr.org) as it currently exists, and keeping the 5-tier system available on SRTR’s beta website (http://beta.srtr.org) while the committee considers future changes in response to feedback received.

Future changes SRTR will be exploring at the request of the Visiting Committee include the following:

presenting other components of patient outcomes in a manner that better compliments the 1-year survival, eg, deceased donor transplant rate and mortality rate on the waiting list;
presenting both living donor and deceased donor volume to give patients a better sense of liver and kidney programs that perform relatively large proportions of living donor transplants.

SRTR is working on implementing a test version of these changes, which will be presented to the Visiting Committee at its upcoming quarterly meeting on July 25, 2017. At that time, the Visiting Committee will consider the revisions and make a recommendation for a path forward for SRTR’s main public website. This recommendation will be part of an ongoing process, in an effort to maintain a consistent improvement system for the SRTR website that meets the needs of our patients.

Please feel free to reach out to SRTR at SRTR@SRTR.org for further information.

Sincerely,

Bertram Kasiske, MD FACP John Gill, MD, PhD Susan Gunderson, MHA

SRTR Director Visiting Committee Co-chair Visiting Committee Co-chair

Posted: 5/18/2017

Now Available: SRTR Webinar on Website and 5 Tiers

SRTR held a webinar on April 19, 2017 about the new website and the 3 tiers vs. 5 tiers. The recording of the webinar is now available on the SRTR YouTube channel. Subscribe to the channel for future updates.

Watch webinar.

Posted: 5/4/2017

Kidney Offer Acceptance and Multi-Organ Reports on Secure Site: Comment deadline April 30

SRTR is working toward integrating kidney offer acceptance behavior and multi-organ transplant information into the program-specific reports. The multi-organ reports will provide descriptive information on multi-organ transplants performed by the program. Specifically, the reports present the number of completed multi-organ transplants, program-specific and national graft failure rates involving the component organs, and program-specific and national patient death rates. The kidney offer acceptance reports have three broad goals: provide general offer acceptance information in the public PSRs, give detailed information to programs and CUSUM reports on the secure site, and communicate kidney offer acceptance information to organ procurement organizations (OPOs) through the secure site. Each report is currently being previewed on the SRTR secure site*.

SRTR is seeking comments on the reports. The comment deadline is April 30. After evaluating the feedback received and making the necessary adjustments, SRTR expects to include kidney offer acceptance and multi-organ transplant information in the June 2017 PSR release. Submit your comments to srtr@srtr.org.

* Secure site access is only available to transplant program administrators and delegates.

Posted: 4/20/17

SRTR to Host Webinar on New Website and Tiered Outcome Assessments

The Scientific Registry of Transplant Recipients (SRTR) plans to host an informational webinar about the new SRTR website and tiered outcome assessment systems. SRTR’s goals are to describe the motivation behind the changes, compare and contrast the 3-tier and 5-tier outcome assessment methodologies, and address common questions about the two systems. Information will be provided as to how interested parties may submit feedback regarding the website and outcome assessment systems. Space is limited, pre-register for the event today:

Date/Time: Wednesday, April 19, 2017, 1 – 2 p.m. CDT.

Link: https://goo.gl/Hxyr2C

Posted: 4/7/2017

SRTR Reverted to 3-Tier System on Public Website - Comments are welcomed

In December 2016, the Scientific Registry of Transplant Recipients (SRTR) replaced the “3-tier” public rating assessment of transplant center performance on its website with a “5-tier” assessment, with the goal of improving the usefulness of outcome information for transplant patients.

In response to feedback received from members of the transplant community regarding the lack of adequate time to review the new 5-tier rating system prior to implementation, HRSA requested that SRTR transfer the 5-tier rating to an alternate, publicly available beta site to undergo further review and identification of areas for improvement. The SRTR website’s outcome assessment information reverted to the 3-tier system on Tuesday, February 21, 2017. Your comments and feedback about the 5-tier system on the beta site and/or the 3-tier system are welcomed, and may be submitted to SRTR by contacting us.

HRSA and SRTR remain committed to seeking and incorporating input from all stakeholders, especially patients, so that we can continually improve the SRTR web site and make outcome information more transparent and understandable for patients and their caregivers.

Posted: 2/16/2017

Preview Kidney Offer Acceptance & Multi-Organ Transplant Reports

SRTR is working towards integrating kidney offer acceptance behavior and multi-organ transplant information into the program-specific reports. A preview of both reports will be released on the SRTR secure site on February 22, 2017.

The multi-organ reports will provide descriptive information on multi-organ transplants involving the program. Specifically, the reports present the number of completed multi-organ transplants, program-specific and national graft failure rates involving the component organ, and program-specific and national patient death rates. All reported outcomes are descriptive.

The kidney offer acceptance reports will have three broad goals: provide general offer acceptance information in the public reports, give detailed information to programs, and communicate relevant information to organ procurement organizations (OPOs). Thus, three separate reports will be previewed on the SRTR secure site:

Draft Program-Specific Reports (PSRs). Offers acceptance information SRTR plans to integrate into the PSRs.
Program Offer Acceptance Reports. Includes detailed information on program-specific offer acceptance behavior. Specifically, two- and one-sided CUSUM charts will be provided over a four-month period, and detailed offer acceptance information on important subgroups of offers. This report will not be integrated into the public reporting and will remain on the secure site, assessable only by the corresponding program.
OPO Offer Acceptance Report. Provides detailed information on the programs likely to accept offers for kidneys at-risk of discard. This report will not be integrated into the public reporting and will remain on the secure site, assessable by every kidney program and OPO.

To help programs prepare for the reports, blinded previews of each report have been released on the secure site. The draft PSRs may be integrated into the June 2017 PSR release; feedback on the reports is greatly appreciated.

Posted: 2/3/2017

Now Available: January 2017 PSRs and OSRs

Program-Specific Reports.

OPO-Specific Reports.

Stay up to date on PSR and OSR reporting timelines.

Posted: 1/5/2017

The Living Donor Collective: SRTR to Launch a Pilot Project to Create a Registry of Living Donors

The Scientific Registry of Transplant Recipients (SRTR), under contract with the Health Resources and Services Administration of the U.S. Department of Health and Human Services, is pleased to announce that they will launch a pilot project with 16 transplant programs that will establish a registry of living donors entitled the "Living Donor Collective," to follow long-term health outcomes after living donation.

SRTR’s plan is to establish a living donor registry in which participating transplant programs register all potential living donor candidates evaluated at their center. Data on all potential living organ donors will be submitted to SRTR at the beginning of their evaluation by the assessing transplant center, and aspects of their physical and psychosocial well-being will be followed up by SRTR. SRTR will provide support for coordination time to conduct this pilot study at each program, acknowledging that during this exploratory start-up study additional time and effort will be required to conduct the project.

This pilot project will allow SRTR to explore the logistics of enrolling potential living donors and test the possibility of direct follow-up with the registered participants without relying on OPTN data collection. All registered participants will be contacted for periodic surveys, and smaller numbers of participants will be contacted for more detailed, targeted surveys. Additional long term health outcomes will also be ascertained through linkages to various electronic data sources, including pharmacy prescription fill claims to determine outcomes such as treatment of end-stage renal disease, and complications such as diabetes, depression, and hypertension. SRTR will assess the outcome difference between the two groups for the long term effects of donation.

The pilot phase of establishing the registry is anticipated to last two years. It is projected that the first donors will be enrolled in the third or fourth quarter of 2017. Once the pilot phase is completed by the end of 2018, the registry can then be incrementally expanded to eventually include most if not all potential living donors evaluated at transplant programs in the US.

Posted: 12/21/2016