Penn–led study pinpoints areas of improvement for organ procurement organizations, could lead to more lifesaving transplants.
Across the country, there are 58 Organ Procurement Organizations (OPO), which are responsible for recovering and distributing organs and tissues for life–saving and life–enhancing transplants. But according to a study published in the American Journal of Transplantation, there seem to be significant differences in the results of life–saving efforts.

Researchers from the Perelman School of Medicine at the University of Pennsylvania, in partnership with ORGANIZE – a non–for–profit organization based in New York which leverages health data to end the organ donor shortage by applying smarter technologies, utilizing social media, building more creative partnerships, and advocating for data–driven policies – The Bridgespan Group – a global nonprofit organization that collaborates with mission–driven leaders, organizations, and philanthropists to break cycles of poverty and dramatically improve the quality of life for those in need – and Gift of Life Donor Program – an OPO which serves the eastern half of Pennsylvania, southern New Jersey, and Delaware – evaluated the metrics and criteria used to measure OPOs across the country, and found significant discrepancies in how potential donors are evaluated and identified.

In this study, researchers utilized national data on inpatient deaths in the United States to estimate the potential supply of deceased organ donors, and used these data, in combination with State Inpatient Databases (SIDs) to develop new metrics of OPO performance that better reflect the true deceased donor supply in each geographic area. The research team identified potential deceased donors based on specific criteria such as a ventilated inpatient death of a patient 75 years or younger, without multi–organ system failure, sepsis, or cancer, and whose cause of death was consistent with organ donation – which includes neurologic determination of death (DNDD) or circulatory determination of death (DCDD). To validate their estimates of a potential deceased donor in administrative data, the team compared their approximations to patient–level data from two large OPOs in order to determine the potential for donation.

Currently, methods of measuring OPO performance and donation rates rely on self–reported numbers of “eligible deaths,” which fails to capture all potential deceased donors, with 20 to 25 percent of actual deceased donors not meeting eligible death criteria. Due to this discrepancy, there has not been a reliable way to compare and benchmark OPOs. Furthermore, because classification of “eligible deaths” fail to capture the number of actual donors, it has been nearly impossible to accurately quantify the potential gains in lifesaving transplants with increased organ donation rates across the country. As a result, researchers agree that a standardized set of metrics will allow for comparisons of OPO performance and donation rates in different regions, and they will help to identify areas where proven best practices can be implemented in order to improve donation rates.

“During our data analysis, we found that using our new metrics, we could identify the geographic areas with the greatest potential gains in lifesaving organ transplants with maximized donation rates,” said lead author, David S. Goldberg, MD, MSCE, an assistant professor of Medicine and Epidemiology at Penn.