1. Key performance indicators (KPIs) for deceased donor kidney retrieval Chris Callaghan On behalf of Working Group 3, NORS Review Implementation Board Renal Transplant Services Meeting, March 2016

2. Background

3. WG3 – KPIs for NORS Role: to develop new KPIs for NORS teams – 1) Operational (data requirements, availability, mobilisation time, response to clinical incidents), some have £ consequences – 2) Quality (organ-specific), in development, applied from 2017, not £ consequences, for comparison Discussions with key stakeholders (AGs, NRG) Presentation to the NORS Implementation Board

4. Organ-specific KPIs for NORS Four domains – 1) Organ damage – 2) Quality of communication – 3) Graft outcome – 4) Timeliness of retrieval Background, WG3 recommendation

5. Organ-specific KPIs for NORS Organ damage – Currently coded as ‘moderate’ (requiring surgical repair) or ‘severe’ (unusable) – Funnel plots, by NORS team – WG3 recommendation: continue with the above, await further electronic coding (J Asher)

6. Organ-specific KPIs for NORS Quality of communication – By phone, from retrieval to implanting teams – WG3 recommendation: only if concern about usability (damage, perfusion, parenchyma, anatomy, vessels), coding to be developed

7. Organ-specific KPIs for NORS Graft outcome – Relevant to retrievals, evidence-based, risk- adjusted, adequate statistical power – WG3 recommendation: not directly relevant to kidney transplantation; decision for transplantation rests with implanting team

8. Organ-specific KPIs for NORS Timeliness of retrieval – No clear evidence of impact on graft outcome, but overall quality indicator – WG3 recommendations: % thresholds KTS to start of perfusion (DCD) Start of perfusion to nephrectomy (DBD / DCD, multi-organ / kidney-only, first / second) Nephrectomy to kidney in box (multi-organ / kidney-only)

9. Thank you