Operational Risk Intelligence for Transplant

Stop losing candidates to paperwork, expirations, and silent gaps.

TransTrack is the offline-first transplant operations platform that sits between your EHR and OPTN/UNet. It surfaces the non-clinical reasons candidates get inactivated — and tells your coordinators exactly which intervention will move the score the most.

0 known vulnerabilities 100% offline by default AES-256 at rest (SQLCipher) No cloud, no AI black box
The problem

Transplant operations don't fail clinically. They fail operationally.

Most candidates aren't lost because of medicine. They're lost because an evaluation expired, an insurance form sat in a queue, labs aged out, or a status change slipped through three handoffs. Existing tools — UNet, EHR transplant modules, legacy systems, spreadsheets — weren't built to catch any of that.

EX

Expirations slip past

Evaluations, labs, and aHHQ documents quietly age out of currency. By the time a coordinator notices, the candidate has already been moved to inactive.

BA

Non-clinical barriers stall

Insurance, transport, caregiver support, financial review — these are the real blockers. They live in inboxes and spreadsheets, not in your transplant system.

CH

Status churn is invisible

Candidates flapping between active and inactive create downstream risk that no UNet view, EHR module, or dashboard surfaces in time to intervene.

Why TransTrack is different

Six things no other platform in this space does.

UNet does allocation. EHRs do encounters. Legacy transplant systems do data entry. TransTrack does the one thing none of them do well: tell you, in real time, which candidates are about to slip — and why — and what to do about it.

Unique
01

An Inactivation Risk Engine that explains itself

Deterministic, auditable scoring with full per-factor decomposition (SHAP-style additive) and 30 / 60 / 90-day calibrated probabilities. No black-box ML. No cloud inference. Same inputs → same output, every time.

Unique
02

Counterfactual interventions, ranked by impact

"If you resolve this insurance barrier, the score drops from 78 to 41." TransTrack hands the coordinator the highest-impact action first — with the projected score change already calculated.

Unique
03

The Transplant Clock — a real-time operational pulse

Time-since-last-update, open barriers, lab gaps, next expiration, team load, and a live pulse rate that rises as risk accumulates. All computed locally. A heartbeat for the entire program.

Unique
04

Truly offline-first — your PHI never leaves the building

AES-256 SQLCipher database, deterministic encryption, no telemetry, no cloud calls, no external AI. Air-gappable by design. The optional server tier is yours, on your infrastructure, when you want it.

Unique
05

Tamper-evident audit at the database layer

Append-only audit log with a SHA-256 hash chain enforced by database triggers — UPDATE and DELETE are physically blocked. A verification endpoint proves chain integrity to your auditors.

Unique
06

Sits between EHR and OPTN — instead of replacing them

FHIR R4 + HL7 v2 in. OPTN-shaped exports out. TransTrack doesn't try to be your EHR or your registry. It fills the operational layer the others ignore — coordination, readiness, and inactivation prevention.

Side by side

How TransTrack compares

Most teams cobble together UNet, an EHR module, a couple of spreadsheets, and a vendor system from the 2000s. Here's what each actually delivers.

Capability TransTrack UNOS UNet EHR transplant module Legacy systems · Spreadsheets
Operational risk intelligence (non-clinical inactivation) Core focus, with explainable scoring — Allocation only — Encounter-centric — Manual tracking
Counterfactual "what if" interventions Ranked by score impact
Offline-first, no cloud required AES-256 local SQLCipher Cloud-only Cloud / hospital network Mixed
Tamper-evident audit (DB-level immutability) SHA-256 hash chain + triggers App-level only App-level only
FHIR R4 + HL7 v2 ingestion MLLP/TLS, ADT/ORU, ACK Vendor-specific
Full clinical calculator suite (MELD/MELD-Na/3.0/PELD/LAS/KDPI/EPTS) Reference-grade, audited Partial
Real-time operational pulse / Transplant Clock Computed locally
21 CFR Part 11 architecture Validation package included N/A Partial
Deployable on-prem or fully air-gapped

UNOS UNet, OPTN, Epic, Cerner, OTTR, Phoenix and other names are trademarks of their respective owners and are referenced for comparison only.

What's inside

An entire transplant operations stack — in one signed binary.

Built as a single Electron desktop app or a Postgres-backed thin client. Same UI. Same code. Your choice of deployment.

RI

Inactivation Risk Engine v2

8-factor weighted model, calibrated 30/60/90-day probabilities, center-level dollar-impact projection, recalibratable per site during PQ.

TC

Transplant Clock

Pulse rate (Hz), operational freshness, team load indicator, average resolution time, next expiration countdown.

WL

Waitlist & candidate management

Demographics, evaluations, configurable readiness indicators, status workflows, search and filter at scale.

BA

Readiness barriers

Track non-clinical obstacles — insurance, logistics, caregiver support — assigned to social work, financial, or coordinator roles.

OO

Organ offer state machine

PENDING → ACCEPTED_PROVISIONAL → ACCEPTED_FINAL / DECLINED / EXPIRED / RESCINDED, with structured decline-reason codes.

PT

Post-transplant follow-up

Transplant events, immunosuppression regimens, rejection episodes, biopsies, post-tx readmissions.

LD

Living donor workflow

Separate donor record, evaluation steps, status state machine, auto-generated 6/12/24-month OPTN Policy 14-style follow-ups.

FH

FHIR R4 + HL7 v2

Inbound MLLP/TLS with ACK generation, ADT^A01/A03/A04/A08 + ORU^R01, FHIR R4 Patient/Observation/Encounter/MedicationRequest/ AllergyIntolerance.

CA

Calculators

MELD · MELD-Na · MELD 3.0 · PELD · LAS · KDPI/KDRI · EPTS — with percentile mapping. Reference-only; allocation stays in UNet.

AU

Hash-chained audit

Append-only with DB-trigger UPDATE/DELETE blocks. SHA-256 prev/ entry hashes. Verification endpoint for auditors. Optional SIEM forwarding.

SO

Hospital SSO + MFA

SAML 2.0, OIDC, TOTP MFA with recovery codes, account lockout, password policy + history. Argon2id at rest.

DR

Backup & disaster recovery

Encrypted local backups, restore tooling, validation IQ/OQ/PQ templates, runbooks, and incident response policies in the box.

Compliance posture

Designed for the audits you'll face — not the ones you won't.

TransTrack is architected to support HIPAA Security Rule controls and aligned with 21 CFR Part 11 electronic-records requirements. "Aligned" describes the design controls — formal certification is performed by the deploying organization.

HIPAA Security Rule
Architected to support
21 CFR Part 11
Designed for alignment
GAMP 5 / ISO 14971
Risk register included
Validation package
IQ / OQ / PQ templates

See it run on your own data — entirely offline.

Download the Windows, macOS, or Linux build. Or build from source in three commands. No accounts, no cloud, no telemetry.

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