LAUSR

C the Organ Procurement and Transplant Network and CMS use 1-year patient and graft survival as metrics to flag transplant programs. Waitlist and longerterm posttransplant outcomes are publicly reported and have been suggested as regulatorymetrics, but both involve factors outside the transplant center. We tested how well the current survival metrics capture these other dimensions. We evaluated transplant programs between 2011 and 2016 using hierarchical regression based on 2017 Scientific Registry of Transplant Recipient risk adjustment models. We used mixed-effect Poisson regression with center and donor service area–level random intercepts for waitlist metrics and center-level shared frailty Cox regression for posttransplant metrics. We ranked centers' risk-adjusted performance from 1 (best) to N (worst) based on center-level random effects from these models and correlated 1-year posttransplant outcomes