Biden administration plans overhaul of US organ transplant system

The system has been criticized for wasted organs, errors, and patient deaths.

March 22, 2023, 4:24 PM

The Health Resources and Services Administration announced plans to overhaul the U.S. organ transplant system, after congressional scrutiny of the current operation — which critics said has poor oversight that has led to wasted organs, serious errors, and patient deaths.

The department says it aims to modernize the IT systems, improve transparency, and solicit contracts from various groups to manage various parts of the organ transplant system. Biden’s proposed 2024 budget also includes a $36 million increase in investment in the organ transplant system.

HRSA, an agency in the U.S. Department of Health and Human Service, also launched an online dashboard sharing information about organ donors and transplant waitlists.

“Every day, patients and families across the United States rely on the Organ Procurement and Transplantation Network to save the lives of their loved ones who experience organ failure,” said Carole Johnson, HRSA Administrator, in a statement. “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.”

PHOTO: Team of surgeon doctors are performing heart surgery operation for patient from organ donor to save more life in the emergency surgical room
STOCK PHOTO/Getty Images

The U.S. organ transplant network currently operates as a partnership between HHS and the United Network for Organ Sharing, or UNOS, which has held the contract to manage the system since 1986. UNOS both runs the logistical system that distributes organs and decides how to prioritize distribution. It oversees 56 Organ Procurement Organizations, which are responsible for recovering organs for transplant.

But a government review, reported by the Washington Post last summer, found that UNOS relied on out-of-date technology and didn’t allow appropriate scrutiny of its systems by government officials. The Senate Finance Committee found in an investigation that there were over 1,000 complaints filed against the system between 2010 and 2020. Most of the 56 Organ Procurement Organizations are underperforming, according to data from CMS.

“For too long it’s been clear that UNOS has fallen short of the requirements for this contract and the expectations of Americans waiting for a transplant,” Senate Finance Committee Chair Ron Wyden, D-Ore, said in a statement.

HRSA says opening up the transplant network to more contracts will increase competition and promote innovation.

In a statement, UNOS said that it supports the changes outlined by HRSA. “We welcome a competitive and open bidding process,” the organization said in a statement to ABC News.

“We believe we have the experience and expertise required to best serve the nation’s patients and to help implement HRSA’s proposed initiatives.”

Over 100,000 people in the U.S. are awaiting organ transplants.