# Veteran Access and Limitations to Organ Recovery (VALOR)

> **NIH NIH R01** · EMORY UNIVERSITY · 2022 · $584,917

## Abstract

Abstract: Deceased donors provide lifesaving gifts to patients with chronic organ failure. Organ donation
occupies a unique position in American healthcare, as donation care is provided without cost to the patient or
their family and is mandated to be provided without bias to age, disability, race, or national origin by federal
contractors known as organ procurement organizations (OPOs). Previous regulatory measures of OPO
performance did not allow adequate objectivity, reliability, and transparency into procurement practice and
have been replaced by a new metric introduced by this study's authors. Analyses using this metric reveal that
older persons, minorities, and those living in poor, rural, and remote areas receive lesser access to organ
donation. Veterans Administration Medical Centers (VAMCs) represent the largest single hospital system in the
United States, and serve a population recognized to be underserved in many aspects of health and medicine.
We have developed preliminary data showing that VAMCs recover deceased donor organs at a rate of 4% that
of non-VA hospitals. The basis for this disparity is unclear, but given the high concentration of vulnerable and
underserved groups at VAMCs, there is a strong imperative to improve donation access for these patients.
 In this proposal, we will leverage VAMCs' unparalleled electronic health records (EHRs), which offer
detailed information on longitudinal patient care and outcomes, to enumerate the potential supply of organ
donors nationwide over a 10-year historical period. We will use physiologic, laboratory, and radiographic data
to define potential donor quality and estimate transplant yields at varying levels of donation performance
relative to non-VA hospitals. We will also interview patients, critical care nurses and physicians at VAMCs, and
OPO personnel to gather their experiences and perceptions regarding barriers to more effective donor
recovery from these institutions. We will use findings from these qualitative and VA EHR studies to inform a
consensus conference on best practices for improved organ donation care at VAMCs in year 2 of our project.
 Based on the findings of the first two aims in this study, we will create a model for improved VAMC
donation care using a large, nationally-representative sample of VAMCs and their attendant OPOs. We will
introduce a clinical decision support tool into VA EHR to maximize referral of potential donors. Study staff will
integrate with OPOs in responding to VAMC referrals, utilizing VA EHR sources to assist in evaluating patients
for donation. Study coordinators will facilitate workflow between VAMC and OPO staff, supporting and
monitoring adherence to best practices defined in the consensus conference. We will conduct a follow-up
stakeholder meeting to assess perceptions of the pilot program's efficacy among VAMC providers, OPO staff,
and veteran and patient advocacy groups from within the study area.
 Together, this study's findings will n...

## Key facts

- **NIH application ID:** 10365618
- **Project number:** 1R01MD017046-01
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Raymond J Lynch
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $584,917
- **Award type:** 1
- **Project period:** 2022-06-10 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10365618

## Citation

> US National Institutes of Health, RePORTER application 10365618, Veteran Access and Limitations to Organ Recovery (VALOR) (1R01MD017046-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10365618. Licensed CC0.

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