Organ Procurement and Transplantation Network: Equity in Access to Transplant Dashboard

This dashboard monitors system-level and factor-level trends related to access to deceased donor transplants among candidates on the waiting list for an organ transplant in the United States.

The measures shown in the dashboard are derived from an access to transplant score, or ATS. The ATS summarizes into a single number a candidate’s relative likelihood of receiving a deceased donor transplant, based on a number of factors, including:

  • Age
  • Body mass index, or BMI
  • Ethnicity
  • Education
  • Urban/rural
  • Community risk score
  • Insurance type
  • Gender
  • Citizenship
  • Blood type

Each waiting list candidate’s ATS is calculated based on the association of these factors with the rate of deceased donor transplantation.

This equity dashboard tool offers insights into the impact of previous policy changes on disparities in transplant access and may help identify the need for future policy refinements.

The ATS standard deviation measures the variation, or disparity, existing between candidates’ access to timely deceased donor organ transplantation. However, this measurement excludes variation due to policy-intended factors related to specific organs, including:

  • Dialysis time for kidneys
  • Model end stage liver disease, or MELD score, for livers
  • Lung allocation score, or LAS, for lungs

Lower ATS standard deviations reflects less disparity – i.e., increased equity – in transplant access among waitlisted candidates.

The two graphed curves displaying system-level trends reflect three organ allocation systems – kidney, liver, and lung – averaged together in two different ways:

  • A usual “average”, in which each organ system is equally weighted (33% each).
  • A waiting list population-weighted average, in which kidney allocation will have the greatest influence since the size of the kidney waiting list greatly exceeds other organs.

Both curves show that overall allocation equity has improved over time. This improvement is associated with reductions in disparities associated with the implementation of the Kidney Allocation System, or KAS, in December, 2014.

The OPTN is in the process of expanding equity calculations to include other organ systems, such as heart allocation.