Evaluating the Effectiveness of OPTN Regulations in Organ Transplantation
Presentation Type
Poster
Student
Yes
Track
Health Care Application
Abstract
Organ transplantation is often the only therapy available to patients with end-stage organ failure. In 2024, over 48,000 transplants were performed in the US, while another 67,000 candidates joined the national waitlist. The Organ Procurement & Transplantation Network (OPTN) manages the national transplant system and oversees the operation of transplant programs (i.e., hospitals that perform transplants). The OPTN has historically monitored transplant program performance using 1-year post-transplant survival metrics. Recently, the OPTN introduced a new set of criteria with additional evaluation metrics to improve performance monitoring. Our study investigates the effectiveness and possible limitations of these regulations using a simulated environment. As a first step, we aim to quantify the prevalence of ‘false flagging’, i.e., the likelihood that a well-performing transplant program is incorrectly flagged and vice-versa. We develop a Monte Carlo simulation framework comprising three phases: (i) preliminary phase, where we estimate patients’ pre- and post-transplant mortality; (ii) simulation phase, where we assign patients to virtual transplant programs and generate simulated patient outcomes; and (iii) evaluation phase, where we assess the accuracy of the new metrics. Because true program-level risks are unobservable, we artificially designate certain programs as high-risk and simulate patient outcomes using preliminary regression models. The models are calibrated using national data on adult first-time kidney transplant candidates waitlisted between 2012 and 2019. Our findings aim to substantiate the OPTN’s efforts to refine performance metrics, prioritize patient safety, and promote increased utilization of deceased-donor organs.
KEYWORDS: organ transplantation, Monte Carlo simulation, health policy, data science in healthcare.
Start Date
2-7-2025 1:00 PM
End Date
2-7-2025 2:30 PM
Evaluating the Effectiveness of OPTN Regulations in Organ Transplantation
Volstorff A
Organ transplantation is often the only therapy available to patients with end-stage organ failure. In 2024, over 48,000 transplants were performed in the US, while another 67,000 candidates joined the national waitlist. The Organ Procurement & Transplantation Network (OPTN) manages the national transplant system and oversees the operation of transplant programs (i.e., hospitals that perform transplants). The OPTN has historically monitored transplant program performance using 1-year post-transplant survival metrics. Recently, the OPTN introduced a new set of criteria with additional evaluation metrics to improve performance monitoring. Our study investigates the effectiveness and possible limitations of these regulations using a simulated environment. As a first step, we aim to quantify the prevalence of ‘false flagging’, i.e., the likelihood that a well-performing transplant program is incorrectly flagged and vice-versa. We develop a Monte Carlo simulation framework comprising three phases: (i) preliminary phase, where we estimate patients’ pre- and post-transplant mortality; (ii) simulation phase, where we assign patients to virtual transplant programs and generate simulated patient outcomes; and (iii) evaluation phase, where we assess the accuracy of the new metrics. Because true program-level risks are unobservable, we artificially designate certain programs as high-risk and simulate patient outcomes using preliminary regression models. The models are calibrated using national data on adult first-time kidney transplant candidates waitlisted between 2012 and 2019. Our findings aim to substantiate the OPTN’s efforts to refine performance metrics, prioritize patient safety, and promote increased utilization of deceased-donor organs.
KEYWORDS: organ transplantation, Monte Carlo simulation, health policy, data science in healthcare.