Scientific Registry of Transplant Recipients: Collecting, analyzing, and reporting data on transplantation in the United States
Section snippets
Historical background
The first successful kidney transplant in the US was performed in 1954. However, large numbers of transplants were not performed routinely until the late 1960s (Table 1). In 1969, the Southeastern Regional Organ Procurement Program (SEROPP) was formed to help transplant centers procure organs. One of the seven original organ procurement programs funded by the US government, SEROPP subsequently became the Southeastern Organ Procurement Foundation (SEOPF), the precursor to United Network for
SRTR operational structure
The Division of Transplantation in the Healthcare Systems Bureau at HRSA provides oversight of the SRTR contract. The SRTR Project Director, Deputy Project Director, and Director of Operations oversee a team of SRTR Senior Staff. The 18 Senior Staff are transplant clinicians and experts in operations research, histocompatibility, health care economics, biostatistics, and epidemiology. The Senior Staff work closely with SRTR support staff to provide:
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Data and analytical support.
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Publications and
Principal SRTR tasks
The SRTR mission is to “support the transplant community with statistical analyses to improve patient outcomes.” To fulfill this mission, SRTR is required to:
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Maintain a Steering Committee. This committee consists of SRTR leadership, HRSA leadership, and OPTN leadership. It provides oversight of SRTR activities, prioritizes tasks, and addresses issues relevant to the operation of the OPTN and SRTR contracts.
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Maintain an SRTR Technical Advisory Committee (STAC). This committee is made up of nine
Overview
SRTR receives data collected by other organizations, manages and analyzes these data, and supplies data, summary reports, and analyses to the transplant community (Fig. 2). Data in the SRTR database are largely from OPTN (from transplant centers, OPOs, and histocompatibility laboratories), and also from the Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration Death Master File (SSADMF). SRTR processes all of the data it receives and provides information upon
Health Resources and Services Administration
Ultimately, HHS is responsible for administering deceased donor organ allocation in the US (Fig. 1). SRTR provides data and data analyses to HRSA as necessary and as defined in its contract with MMRF/CDRG. In addition to data reporting outlined in the contract and described below, Congress has mandated that HHS report every 2 years on the involvement of HHS in organ transplantation. SRTR provides much of the data and helps HHS produce this Biennial Report to Congress. The Secretary of HHS
Program-specific reports
The PSRs contain information on wait-list candidates, deceased donors, living donors, transplant recipients, and outcomes for all OPTN-approved transplant programs in the US. These include heart, intestine, kidney, liver, lung, and pancreas programs. In addition, PSRs are produced for two types of multi-organ transplant programs, heart–lung and kidney–pancreas, since OPTN separately certifies these types of programs. If an institution maintains multiple transplant programs, e.g., a kidney
Conclusion
SRTR is a registry that contains current and past information on the full continuum of transplant activity in the US. Data in the registry come largely from OPTN, and from CMS and the SSADMF. SRTR employs an extensive system involving several technologies to combine, reorganize, and clean data to create the SRTR database. Data in the database are then evaluated, reorganized, and eventually extracted into more useful forms, such as the SAFs. Researchers and clinicians request the SAFs and other
Acknowledgments
This work was conducted under the auspices of the Minneapolis Medical Research Foundation, contractor for the Scientific Registry of Transplant Recipients, as a deliverable under contract no. HHSH250201000018C (US Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation). As a US Government-sponsored work, there are no restrictions on its use. The views expressed herein are those of the authors and not
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