Biden administration plans to break up monopoly power of U.S. organ transplant system

The Biden administration on Wednesday announced it aims to overhaul and modernize the organ transplant system in the U.S. with a plan that includes breaking up the monopoly power that has run the system for decades.

The Health Resources and Services Administration (HRSA), an agency under the Department of Health and Human Services, released a set of actions it plans to take as part of a broader modernization effort for the organ transplant system. As part of the plan, HRSA says it will solicit multiple contracts to manage the Organ Procurement and Transplantation Network (OPTN) “in order to foster competition.”

Right now, the nonprofit United Network for Organ Sharing (UNOS) is the only group contracted by the government to run the system, and it has come under criticism over its management of the massive system that allocates organs to patients.

HRSA reports more than 104,000 patients are on the national transplant list, waiting for kidneys, livers, hearts and other organs as part of their medical care. The nearly 43,000 transplants that occurred last year hit a record, but still fell short of the high demand from the long waiting list. Seventeen people die each day waiting for an organ transplant, according to the agency.

The HRSA plan did not specify exactly how many contracts it hopes to tack on or how the division of duties would play out, but added that the move also aims to ensure the independence of the OPTN Board of Directors.

UNOS on Wednesday said in a statement that it supports the HRSA’s plan to revamp the organ transplant system and is committed to working with the HHS and HRSA on the efforts.

“We welcome a competitive and open bidding process for the next Organ Procurement and Transplantation Network (OPTN) contract to advance our efforts to save as many lives as possible, as equitably as possible,” the nonprofit said.

The HRSA plan also includes rolling out data dashboards to provide more information on organ donation and transplant and modernizing the agency’s IT system.

President Biden’s budget proposal for the fiscal 2024 suggested more than doubling the funding for organ procurement and transplantation to $67 million next year, according to the release, and requested that Congress make updates the National Organ Transplant Act.

“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 HRSA Administrator Carole Johnson. “That is why we are taking action to both bring greater transparency to the system and to reform and modernize the OPTN.”


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