Federal regulators have proposed a major shake-up of the system that allocates human organs for transplantation.
The Health Resources and Services Administration outlined plans Wednesday to reorganize the federal Organ Procurement and Transplantation Network, which the United Network for Organ Sharing, also known as UNOS, exclusively administers. The policy would invite other organizations to participate in the organ system, ending UNOS' virtual monopoly.
Having multiple contractors will strengthen the Organ Procurement and Transplantation Network and “foster competition," according to a HRSA news release. “We are taking action to both bring greater transparency to the system and to reform and modernize the [Organ Procurement and Transplantation Network]. The individuals and families that depend on this life-saving work deserve no less,” HRSA Administrator Carole Johnson said in the release.
UNOS has endorsed the proposal. "UNOS supports HRSA’s plan to introduce additional reforms into the nation’s organ donation and transplantation system. We also stand united with HRSA in our shared goal to get as many donor organs as possible to the patients in need while increasing accountability, transparency and oversight," the nonprofit organization said in a news release. "We welcome a competitive and open bidding process for the next [Organ Procurement and Transplantation Network] contract to advance our efforts to save as many lives as possible, as equitably as possible. We believe we have the experience and expertise required to best serve the nation’s patients and to help implement HRSA’s proposed initiatives."
President Joe Biden made organ transplantation a priority in his fiscal 2024 budget request, which asks Congress to nearly double what the U.S. spends on the system to $67 million. The White House also proposed that lawmakers update the National Organ Transplant Act of 1984 to eliminate a cap on the program's budget.
The Biden administration's proposals follow a Centers for Medicare and Medicaid Services regulation issued in 2020 under President Donald Trump that was designed to increase the availability of organs for transplantation.
More than 42,800 organ transplants occurred in the U.S. last year, according to UNOS. About 104,000 people are currently on waiting lists for organs, according to the Organ Procurement and Transplantation Network.
How the new initiative concerning the network will impact transplant and donor hospitals is uncertain without more information from HRSA, said Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association. HRSA appears to have heeded calls from Congress and others to divide responsibilities for distributing organs among multiple organizations rather than relying on UNOS alone, she said.