Report of a consensus conference on transplant program quality and surveillance

Bert L Kasiske, M. A. McBride, D. L. Cornell, R. S. Gaston, M. L. Henry, F. D. Irwin, A. K. Israni, N. W. Metzler, K. W. Murphy, A. I. Reed, J. P. Roberts, N. Salkowski, J. J. Snyder, S. C. Sweet

Research output: Contribution to journalArticlepeer-review

58 Scopus citations

Abstract

Public reports of organ transplant program outcomes by the US Scientific Registry of Transplant Recipients have been both groundbreaking and controversial. The reports are used by regulatory agencies, private insurance providers, transplant centers and patients. Failure to adequately adjust outcomes for risk may cause programs to avoid performing transplants involving suitable but high-risk candidates and donors. At a consensus conference of stakeholders held February 13-15, 2012, the participants recommended that program-specific reports be better designed to address the needs of all users. Additional comorbidity variables should be collected, but innovation should also be protected by excluding patients who are in approved protocols from statistical models that identify underperforming centers. The potential benefits of hierarchical and mixed-effects statistical methods should be studied. Transplant centers should be provided with tools to facilitate quality assessment and performance improvement. Additional statistical methods to assess outcomes at small-volume transplant programs should be developed. More data on waiting list risk and outcomes should be provided. Monitoring and reporting of short-term living donor outcomes should be enhanced. Overall, there was broad consensus that substantial improvement in reporting outcomes of transplant programs in the United States could and should be made in a cost-effective manner. This report describes the results of a consensus conference on the Scientific Registry of Transplant Recipients' program-specific reports and the recommendations for change.

Original languageEnglish (US)
Pages (from-to)1988-1996
Number of pages9
JournalAmerican Journal of Transplantation
Volume12
Issue number8
DOIs
StatePublished - Aug 2012

Keywords

  • OPTN
  • Program-specific reports
  • SRTR

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