The Organ Procurement and Transplantation Network (OPTN), in collaboration with the Health Resources and Services Administration (HRSA), is notifying members that prior COVID-era guidance permitting the use of certain waitlist screening parameters to prevent organ offers is rescinded, effective immediately.
In April 2020, during the COVID-19 emergency, the OPTN issued guidance permitting transplant programs to temporarily implement waitlist screening criteria. This approach enabled candidates to keep accumulating waiting time even if they were not eligible to receive organ offers at that moment. These criteria included setting donor age limits to a minimum of 98 years and a maximum of 99 years.
The COVID-19 public health emergency has ended. Moving forward, transplant programs must return to using the OPTN-approved procedures to temporarily inactivate candidates. This is critical to ensure patient safety and system integrity. It is inappropriate to continue to use excessively narrow donor acceptance criteria or other screening parameters to effectively render a candidate ineligible for organ offers.
Required member actions
- Transplant programs must discontinue the use of donor age acceptance criteria (e.g., 98-99 years) or other screening parameters intended to functionally inactivate candidates.
- Programs must use established inactive status procedures when a candidate is temporarily unable to accept organ offers.
- Listing parameters must reflect clinically appropriate ranges and must not be used to prevent organ offers.
OPTN monitoring going forward
The OPTN will regularly review waitlist parameter data to identify potentially ineffective listing practices. The OPTN may contact programs it identifies as having extreme or implausible acceptance ranges and ask them to review and, if necessary, correct those listings.
The OPTN reserves the right to issue further guidance or formal policies based on its review of waitlist parameter data.
The OPTN appreciates your prompt attention to this matter and your continued commitment to maintaining a safe, fair, and reliable organ donation, procurement, and transplantation system.