*Purpose: The OPTN Final Rule mandates the Scientific Registry of Transplant Recipients (SRTR) to publish understandable reports of transplant rate, waitlist mortality, and posttransplant outcomes. SRTR developed a 5-tier reporting system for each metric to improve accessibility of the public reporting. The association of the 5-tier ratings at listing with all-cause candidate mortality after listing assessed the potential utility of the 5-tier systems.

*Methods: Adult candidates (≥18) listed between July 12, 2011, and June 16, 2014, were included. Archived SRTR program-specific reports determined the pretransplant and posttransplant tiers at listing. Cox proportional hazards models estimated the associations after adjusting for candidate characteristics at listing.

*Results: Table 1 presents adjusted hazard ratios for a 1-tier difference at listing for each rating. (For example, in kidney transplant, 1 additional tier at listing for the transplant rate was associated with a 5% lower hazard of mortality after listing.) For the transplant rate evaluation, one additional tier at listing was associated with lower subsequent mortality in kidney (hazard ratio [HR], _0.930.95_0.97), liver (HR, _0.870.90_0.92), and heart (HR, _0.920.96_1.00) transplantation. For lung transplant patients, the transplant rate rating at listing had a U-shaped association with subsequent patient mortality: highest for programs with above- and below-average transplant rates, and lowest for programs with average transplant rates. One additional tier at listing in the waitlist mortality rating was associated with lower patient mortality in kidney transplantation (HR, _0.940.96_0.99), and one additional tier at listing in the posttransplant rating was associated with lower patient mortality in lung transplantation (HR, _0.900.94_0.98).

*Conclusions: The relative importance of pretransplant and posttransplant program-specific ratings at listing to subsequent candidate mortality was organ specific. Thus, public reporting should clearly emphasize the metrics important for patient survival after listing for a given organ.

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