Time for reform in transplant program–specific reporting: AST/ASTS transplant metrics taskforce

the AST/ASTS Transplant Metrics Taskforce

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

In accordance with the National Organ Transplant Act and Department of Health and Human Services’ Final Rule, the Scientific Registry of Transplant Recipients (SRTR) publicly releases biannual program-specific reports that include analyses of transplant centers’ risk-adjusted waitlist mortality, organ acceptance ratios, transplant rates, and graft and patient survival. Since the inception of these center metrics, 1-year posttransplant graft and patient survival have improved, and center variation has decreased, casting uncertainty on their clinical relevance. The SRTR has recently modified center evaluations by ranking centers into 5 tiers rather than 3 tiers in an attempt to discriminate between programs performing within a tight range, further exacerbating this uncertainty. The American Society of Transplantation/American Society of Transplant Surgeons convened an expert taskforce to examine both the utility and unintended consequences of transplant center metrics. Estimates of center variation in outcomes in adjacent tiers are imprecise and fleeting, but can result in consequential changes in clinician and center behavior. The taskforce has concerns that current metrics, based principally on 1-year graft and patient survival, provide minimal if any benefit in informing patient choice and access to transplantation, with the untoward effect of decreased utilization of organs and restriction of research and innovation.

Original languageEnglish (US)
Pages (from-to)1888-1895
Number of pages8
JournalAmerican Journal of Transplantation
Volume19
Issue number7
DOIs
StatePublished - Jul 1 2019

Fingerprint

Graft Survival
Transplants
Uncertainty
Registries
United States Dept. of Health and Human Services
Transplantation
Mortality
Research
Transplant Recipients

Keywords

  • ethics
  • ethics and public policy
  • organ procurement and allocation
  • patient education
  • registry/registry analysis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Time for reform in transplant program–specific reporting : AST/ASTS transplant metrics taskforce. / the AST/ASTS Transplant Metrics Taskforce.

In: American Journal of Transplantation, Vol. 19, No. 7, 01.07.2019, p. 1888-1895.

Research output: Contribution to journalArticle

the AST/ASTS Transplant Metrics Taskforce. / Time for reform in transplant program–specific reporting : AST/ASTS transplant metrics taskforce. In: American Journal of Transplantation. 2019 ; Vol. 19, No. 7. pp. 1888-1895.
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