Breaking News in the World of Transplant

There is a bill working its way through Congress this week that could change the organ allocation system in the United States.  HR Bill 2544, known as “Securing the U.S. Organ Procurement and Transplantation Network,” states, in part,

“This network is a public-private partnership that links the professionals involved in the U.S. donation and transplantation system. Historically, only one organization has received a contract for managing the network.

The bill expressly authorizes HRSA to award multiple grants, contracts, or cooperative agreements to support the operation of the network and eliminates a cap on the amount of funding available for supporting the network. The bill also specifies that the network shall be operated through awards that are distinct from awards for supporting the operation of the network’s board of directors.”

The primary purpose of this bill being to remove the contract for the allocation of organs from the United Network for Organ Sharing (UNOS) and replace it with a network of smaller, potentially privatized, for-profit, organ procurement agencies.

This is a portion of the information from the congressional report.  The full text can be read here: H. Rept. 118-140 – SECURING THE U.S. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK ACT | Congress.gov | Library of Congress 

 Purpose and Summary

H.R. 2544, the “Securing the U.S. Organ Procurement and
Transplantation Network Act.” introduced by Representatives
Larry Bucshon (R-IN) and Robin Kelly (D-IL), amends the Public
Health Service Act to allow for competition within the Organ
Procurement and Transplantation Network (OPTN) contract
process. The legislation also makes technical changes and
requires the Comptroller General to conduct a review of the
OPTN and submit its findings to the House Energy and Commerce
Committee and the Senate Health, Education, Labor, and Pensions
committee.

In the U.S., procurement of organs from deceased donors for
transplantation is done by organ procurement organizations
(OPOs). OPOs are responsible for working with donor hospitals
to identify opportunities for organ donation, working with
donor families to obtain consent for organ donation, when
necessary, conducting testing to identify potential for disease
transmission or other safety issues, and safely procuring and
transporting all transplantable organs based on OPTN
policies.\4\ There are currently 57 OPOs with each assigned to
their own donation service area (DSA). The Social Security Act
requires than an OPO be a member of the OPTN, a membership
organization that links all professionals in the U.S. organ
donation and transplantation system. The OPTN is responsible
for governing how deceased donor organs are allocated to
individuals on the waiting list.

A single contractor has operated the OPTN since it was
created, and there has been little to no competition for the
contract. This has stifled innovation and hindered efforts to
increase equity in organ allocation, according to a review by
the U.S. Digital Service.\5\ Additionally, this contractor has
been the subject of Congressional investigations and
allegations from patients, families, transplant centers, and
others, of consistent mismanagement, lack of technical
expertise, failure to provide adequate oversight of OPOs, and
risks to patient safety.\6\ In fact, the Centers for Medicare
and Medicaid Services (CMS) has estimated that if OPOs
increased their performance, approximately 5,6000 more organs
per year could be transplanted.\7\

According to the congressional schedule posted on the Majority Leader’s website, House Bill HR2544 is scheduled to come before congress for a vote tomorrow, July 25.  The hearing should be broadcast at www.live.house.gov.  You may have to look for the bill on the schedule to find the hearing livestream.   

This is a developing story and I plan multiple posts to follow the developments and ramifications.  I will also be digging deeper into what this means for the future of transplantation in the United States and for people currently on the list. 

Stay tuned.