The Organ Procurement and Transplantation Network (OPTN) and Health Resources and Services Administration (HRSA) are committed to addressing organ allocation out of OPTN sequence (AOOS) in order to protect public trust, ensure adherence to OPTN policies, increase fairness, and uphold patient safety. Along with the AOOS Workgroup, the OPTN and HRSA have strengthened how organ allocations are reviewed and monitored for compliance and wanted to share a few changes we’ve made to the process for your awareness.
Previously, UNOS supported the Membership and Professional Standards Committee (MPSC) in conducting monthly reviews of organ allocations and frequently reaching out to organ procurement organizations (OPOs) to request additional clarifying information.
As part of the ongoing OPTN Modernization effort, HRSA conducted user research with OPOs and found that this monthly allocation case review did not lead to meaningful OPTN action to address noncompliance with OPTN policies. Given this observation, the OPTN and HRSA are using new monitoring tools including the AOOS Dashboard and OPO Allocation Compliance Reports (PDF - 935 KB), which provide HRSA, the OPTN, patients, and the community at large a more comprehensive way to monitor AOOS instances and trends. These automated and data-driven tools have improved monitoring and should also decrease the number of ad hoc allocation data follow-up requests to OPOs.
As a reminder, OPOs must continue to maintain complete documentation of all organ allocations in accordance with Centers for Medicare and Medicaid Services (CMS) Conditions for Coverage (CfCs), OPTN Final Rule requirements, and OPTN member obligations, and should be prepared to provide documentation upon request by HRSA, CMS, or the OPTN.
Additional information regarding AOOS can be found on the AOOS webpage.