Variation Across Organ Procurement Organizations in Deceased-Donor Kidney Offer Notification Practices.

Area of Science:

• Transplant Surgery
• Organ Allocation Policy
• Nephrology

Background:

• Understanding kidney offer notification practices is crucial for efficient organ allocation.
• Current practices across organ procurement organizations (OPOs) lack clarity regarding offer distribution early in the kidney allocation timeline.

Purpose of the Study:

• To analyze the distribution of kidney offer notifications across different OPOs.
• To identify variations in initial offer batch sizes and their implications for kidney allocation efficiency.

Main Methods:

• Utilized data from 54,631 deceased-donor kidney match runs between 2017 and 2023.
• Merged Scientific Registry of Transplant Recipients data with offer notification timestamps.
• Quantified the number of offers in the initial notification batch for each OPO.

Main Results:

• Initial kidney offer batches varied significantly across OPOs, ranging from 3 to 746 candidates.
• No correlation was found between initial batch size and kidney placement rank or OPO nonuse rate.
• OPOs with the largest initial batches sent more offers than necessary, while those with the smallest sent fewer than needed.

Conclusions:

• Kidney offer notification practices differ substantially among OPOs.
• Many OPOs extend offers more broadly than required for successful kidney placement.
• Optimizing offer notification strategies could minimize unnecessary communications and enhance overall allocation efficiency.