The federal Health Resources and Services Administration announced a plan on Wednesday that would cause some major changes to the United States’s organ transplant system.
The plan includes breaking up the organ transplant monopoly led by the United Network for Organ Sharing, which has handled organ transplants for the past 37 years despite facing heavy criticism.
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Carole Johnson, the administrator of the HRSA, said one of the biggest changes is allowing other non-profits to bid on contracts for certain organs that they are specifically equipped to handle.
“This system and the statute that governs it are almost 40 years old,” Johnson told the New York Times. “Technologies improved. Government processes about transparency have improved. And so the time was ripe for us to do this.”
UNOS welcomed the change and claimed it felt competitive with the other organizations.
“[UNOS] supports HRSA’s plan to introduce additional reforms into the nation’s organ donation and transplantation system,” the network said in a statement to the Washington Post. “We believe we have the experience and expertise required to best serve the nation’s patients and to help implement HRSA’s proposed initiatives.”
UNOS has faced tough criticism in the past due to long wait times on the transplant list, too many organs being discarded, damaged in transit, or not collected, and faulty technology sometimes jeopardizing the transplants. Nearly 104,000 people are on waiting lists for organs, with the most sought-after organs being kidneys.
However, in 2020, a little over 20% of kidney procurement ended with the organ going to waste. Approximately 22 people die each day awaiting transplants, according to the Washington Post.
“What’s so critical to us is ensuring we are doing everything possible to improve the system that patients and families depend on,” Johnson said.
The Biden administration also rolled out a website that will provide detailed, anonymized data on transplant wait lists, donors, and recipients for the first time. The site will also include outcomes for individual hospitals to help patients and their families make decisions about where to go.
Although the proposal has been praised by members of Congress on both sides of the aisle, some experts are worried that the change will do more harm than good. Stephen Gay, the surgical director of the Liver Transplant Program at George Washington University Hospital, said he thinks that the non-profit does a good job of handling something that is in short supply.
Another expert warned the government to make the changes slowly, or it could mess up an already delicate system.
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“The whole transplant system is very delicate; it relies on trust and coordination,” Dr. Arthur Caplan, the director of the Division of Medical Ethics at the New York University Grossman School of Medicine, said. “To reform it, you have to go slowly, for fear that you would cause it to halt as it tries to adjust to new requirements.”
It is not clear when the new changes will take effect, but UNOS’s multi-million multi-year contract comes up for renewal later this year.
