# Aggressive Organ Procurement Organization Report Cards to Safely Increase Kidney Transplantation

> **NIH NIH F32** · JOHNS HOPKINS UNIVERSITY · 2020 · $81,310

## Abstract

PROJECT SUMMARY
Despite a kidney transplant (KT) waitlist of almost 100,000 people, kidneys are recovered from only 10,000
deceased donors annually, resulting in nearly 5,000 waitlist deaths per year. However, there are an estimated
38,000 potential deceased donors per year, and recovery of organs from all potential donors could eliminate
the waitlist. In a recent White House Executive Order, the President cited underperformance of organ
procurement organizations (OPOs) as a major impediment to recovery of organs from all potential donors.
OPOs perform well for "ideal" deceased donors; however, potential improvement lies in the pursuit of
suboptimal kidneys (SOKs), such as those from older donors, donors after cardiac death (DCD), donors
infected with HIV or HCV, donors with prolonged cold ischemia time (CIT), and donors with elevated terminal
creatinine. These organs can be challenging to evaluate, recover, and allocate. Current OPO evaluation
metrics are based on averages: a single, all-encompassing number reflecting "performance" that includes both
the easy and challenging cases. But the important details get lost in this average. No method exists to provide
OPOs with stratified, comparative feedback on their pursuit of SOKs. We previously addressed a parallel
challenge, SOK utilization by transplant centers, using a method that can now be applied to OPOs.
Our goal is to develop an aggressiveness report card (ARC) for OPOs that provides easily interpretable and
clinically relevant stratified feedback. We hypothesize that OPO aggressiveness and performance is a function
of subtype of SOK and that feedback will alter OPO behavior, leading to increased understanding and pursuit
of SOKs, increased KT, and decreased waitlist mortality. Our approach is targeted and collaborative rather
than forced and regulatory, which will improve participation and adoption.

## Key facts

- **NIH application ID:** 9990182
- **Project number:** 1F32DK124941-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Brian Boyarsky
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $81,310
- **Award type:** 1
- **Project period:** 2020-07-01 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9990182

## Citation

> US National Institutes of Health, RePORTER application 9990182, Aggressive Organ Procurement Organization Report Cards to Safely Increase Kidney Transplantation (1F32DK124941-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9990182. Licensed CC0.

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