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Organ Donation

HRSA Reveals Plan to Overhaul Nation’s Organ Transplant System

By Jonathan Springston, Editor, Relias Media

The Health Services and Resources Administration (HRSA) announced it will take several steps to improve the nation’s Organ Procurement and Transplantation Network (OPTN).

First, HRSA has created a new dashboard with data regarding transplant centers, organ retrieval, waitlist outcomes, and other demographic information. Second, HRSA has opened a bidding process seeking multiple companies that could manage the OPTN, while the agency has promised more transparency and better governance. Finally, President Biden’s fiscal year 2024 budget proposal calls for increasing funding for organ procurement and transplantation to $67 million, up from $36 million in fiscal year 2023.

“Every day, patients and families across the United States rely on the [OPTN] to save the lives of their loved ones who experience organ failure,” said HRSA Administrator Carole Johnson. “At HRSA, our stewardship and oversight of this vital work is a top priority. That is why we are taking action to both bring greater transparency to the system and to reform and modernize the OPTN. The individuals and families that depend on this life-saving work deserve no less.”

In February 2022, the National Academies of Sciences, Engineering, and Medicine (NASEM) published 14 recommendations for improving this system. It seems HRSA has adopted some of those ideas, especially regarding the suggestion to provide more and better data.

The United Network for Organ Sharing (UNOS), which is under contract with the federal government to manage the OPTN, said it supports the government’s reform plan and “stand[s] united with HRSA in our shared goal to get as many donor organs as possible to patients in need while increasing accountability, transparency, and oversight.” Although UNOS also indicated it supports a “competitive and open bidding process,” the group did note “we believe we have the experience and expertise required to best serve the nation’s patients and to help implement HRSA’s proposed initiatives.”

The Association of Organ Procurement Organizations (AOPO), which expressed support last year for the NASEM recommendations, said of HRSA’s plan that it is “following these developments closely.”

“We support systemwide improvements and are committed to working with HRSA to ensure we save as many lives as possible through organ donation and transplantation,” AOPO said. “It is critical that any proposed changes are evaluated carefully, thoroughly, and objectively to ensure they do not harm the lives of the patients we are working to save.”

Meanwhile, the National Kidney Foundation (NKF) called HRSA’s proposal “common-sense changes” that are “long overdue.”

“Our current transplant system still relies on antiquated technology and inefficient systems that create life-threatening bureaucracy and delays,” said NKF CEO Kevin Longino. “HRSA’s move to redesign the OPTN contract will allow leaders in technology, artificial intelligence, supply chain management, and other critical business operations to bring their ideas and talent to a system that is in desperate need of reform.”

For more on this and other related subjects, be sure to read the latest issues of Medical Ethics Advisor.