The evolving role of regulatory reporting on patient and donor selection in organ transplantation

Purpose of review To describe the historical and evolving role of quality oversight in the field of transplantation. The review highlights of the prior use and effects of oversight of solid organ transplant centers and discusses potential ramifications of changes for the field. Recent findings There have been a number of studies illustrating unintended consequences associated with regulatory oversight. Although the intent of oversight to ensure safety and high quality of care, research highlights the potential deleterious effects of policies that do not consider the complexities and effects on practice, patient selection and utilization of donor organs in this field. Recent amendment of policy by the Center for Medicare and Medicaid Services (CMS) highlight the recognition and prominence of these concerns and potentially expand opportunities for transplantation prospectively. The historical development and implementation of regulatory reporting in transplantation is unique and the oversight imposed on transplant organizations is particularly high compared with other healthcare contexts. The effects of recent CMS policy changes and any related developments from other regulators and payers will be important to evaluate in the years to come.