Organ Procurement Organizations Enhance Accountability Metrics to Save More Lives

Enhancing Lives: The New Metrics Initiative by AOPO

On May 5, 2026, the Association of Organ Procurement Organizations (AOPO) unveiled a groundbreaking initiative intended to enhance the performance metrics for organ procurement organizations (OPOs) across the United States. This initiative marks a pivotal step in strengthening the accountability of the organ donation framework, with a core objective to save as many lives as possible.

The Need for Improved Measurement

In the backdrop of a burgeoning organ transplant waitlist, with over 100,000 patients awaiting lifesaving transplants, the need for a more accountable and transparent organ donation system could not be more critical. The AOPO's latest submission of refined performance metrics aims to better reflect the operational realities faced by OPOs. The project involves collaboration with 53 OPOs, and Econometrica, Inc., a respected health policy research firm.

Validated Metrics for Accountability

The AOPO proposed four independently validated performance measures for endorsement by the Partnership for Quality Measurement, which evaluates healthcare metrics under contract with the Centers for Medicare & Medicaid Services (CMS). The submission showcases a significant milestone in the ongoing project to boost transparency and ensure accurate performance assessments in the organ donation domain.

1. Referral Rate - This metric tracks the rate at which hospitals refer potential organ donors to OPOs within their service area on a yearly basis.
2. Approach Rate - It reflects the proportion of referred patients who are approached about organ donation in the same area.
3. Authorization Rate - This measures the rate at which approached potential donors consent to organ donation.
4. Donation Rate - This final metric focuses on the overall donation rate, calculating the number of organ donors against the number of potential donors within an OPO's service area each year.

These measures form the initial phase of a broader suite aimed at refining how OPOs' performance is evaluated, addressing issues that have long plagued past assessment methods.

Addressing Challenges

The current regulations under the OPO Final Rule pose significant risks, with nearly half of U.S. OPOs facing potential automatic decertification by late 2026. This situation could lead to a widespread disruption in the organ donation ecosystem, jeopardizing many patients who rely on these systems for their lives. The existing metrics primarily focus on donation and transplant rates; however, critics argue that these don't adequately capture the complexity of the OPO's role, which does not extend to the acceptance of organs by transplant centers. Instead, OPOs are instrumental in coordinating organ donation, making their performance measures essential.

As noted by Dr. Jean O'Connor of Econometrica, “We cannot improve this lifesaving system if we do not measure it accurately.” The reliance on flawed relative ranking systems can endanger the stability of OPOs and impact organ donation negatively.

Collaborative Actions for Change

The collaborative effort between AOPO and Econometrica aims to ensure that the evaluation of OPO performance aligns with the operational realities they navigate. As these new metrics gain traction, the aim is to refine regulatory goals and create a unified approach to organ procurement that maximizes donation opportunities and ultimately saves more lives.

Jeff Trageser, the AOPO President, emphasizes the communal responsibility in this complex framework, stating that “Countless donors, patients and their families are depending on regulators and the donation community working together to protect this delicately complex system.”

The importance of organ donation can’t be overstated; each individual donor can save up to eight lives and improve the quality of life for over 75 people. The AOPO calls on everyone to consider their role in this life-saving initiative. For those interested in becoming donors, registration is accessible online through RegisterMe.org/AOPO50K, a small step that can make a significant impact.

About AOPO and Econometrica

Founded in 1984, AOPO is dedicated to advancing organ donation and transplantation processes within the United States. By fostering communication and collaboration among its member OPOs, AOPO strives for a future where every donation opportunity is capitalized upon, leading to more lives saved. Econometrica, Inc., the consulting partner in this venture, specializes in using data analytics to tackle complex challenges in health policy.

With the introduction of these new metrics, AOPO, along with Econometrica, hopes to redefine how OPOs' performance is assessed, ensuring that all stakeholders are aligned and accountable in their shared mission to save lives.