Resources

Published 19 March 2024

• OPTN Comment

The International Society for Heart and Lung Transplantation (ISHLT) appreciates the opportunity to comment on the OPTN Strategic Plan (2024 – 2027). The Plan encompasses important aspects of organ transplantation and highlights key areas to increase awareness of transplant, improve organ placement, and efficiency in the process.

We agree with the Board's proposed areas of strategic focus. They are of high importance and well selected. The Committee has selected three specific goals: 1) Improve Offer Acceptance Rate, 2) Optimize Organ Use, and 3) Enhance OPTN Efficiency, which are all important objectives. Although it may be inferred to be part of the “Optimize Organ Use” goal, we would prefer to see more explicit attention paid to maximizing the utilization of potentially usable organs, not just those for which OPOs have obtained consent.

The metrics are included in the strategic plan to provide actionable insights and should facilitate informed decision-making while offering perspective on how the plan is progressing. They are intended to provide insight into the progress of overall goals and are closely linked to individual objectives. This plan includes nineteen metrics. Some of the performance metrics should be made more specific (i.e., "Target: Organ Offer Acceptance Rate Increase" could include an attainable goal of "Organ Offer Acceptance Rate Increase of 3%"). Unless goals are specific and measurable, progress cannot be determined.

The Strategic Plan should also include language to emphasize the goal of increasing acceptance rate will not be achieved by allowing OPOs to offer fewer marginal organs. Improving offer acceptance rates sounds positive, but unfortunately it could lead to fewer patients transplanted depending on the method of implementation.

Likewise, the Strategic Plan should include language to emphasize that the goal of reducing time to organ acceptance should not be attained by reducing access to testing of donors for safety purposes.

The OPTN is encouraged to create safety metrics as they implement this Plan.