Scientific Registry of Transplant Recipients: Collecting, analyzing, and reporting data on transplantation in the United States

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Abstract

Founded in 1987, the Scientific Registry of Transplant Recipients (SRTR) operates under a contract from the US government administered by the Health Resources and Services Administration (HRSA). SRTR maintains a database of comprehensive information on all solid organ transplantation in the US. The registry supports the ongoing evaluation of the clinical status of solid organ transplantation, including kidney, heart, liver, lung, intestine, pancreas, and multi-organ transplants. Data in the registry are from multiple sources, but most are collected by the Organ Procurement and Transplantation Network (OPTN) from hospitals, organ procurement organizations, and immunology laboratories. The data include information on current and past organ donors, transplant candidates, transplant recipients, transplant outcomes, and outcomes of living donors. SRTR uses these data to create reports and analyses for HRSA, OPTN committees that make organ allocation policy, and the Centers for Medicare & Medicaid Services to carry out quality assurance surveillance activities; SRTR also creates standard analysis files for scientific investigators. In addition, SRTR and OPTN produce an Annual Data Report and provide information upon request for the general public. Thus, SRTR supports the transplant community with information services and statistical analyses to improve patient access to and outcomes of organ transplant.

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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:

  • 1.

    Data and analytical support.

  • 2.

    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:

  • 1.

    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.

  • 2.

    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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