HRSA Plans to Modernize US Organ Transplant Donation System to Shorten Wait Times, Improve Equity

Citing the need to modernize the US organ transplantation framework, the Department of Health and Human Services Health Resources and Services Administration (HRSA) has announced the Organ Procurement and Transplantation Network (OPTN) Modernization Initiative. The OPTN aims to accelerate progress in areas including technology, data transparency and analytics, governance, operations, and quality improvement and innovation.

To reduce wait times for organs and address racial inequities, the New York Post reported that the initiative seeks to break up the United Network for Organ Sharing (UNOS), a national nonprofit that has run the nation’s organ donation system for nearly 40 years.

Currently, more than 100,000 people in the US await organ transplants, with patients waiting years for donations. 6,000 people a year die while waiting. In addition, the organ donation and subsequent transplant system in the US often suffers from racial inequities, as recent research from the Journal of the American College of Surgeons highlighted regarding access to kidneys for Black patients. A 2019 study from Penn Medicine and the Paris Transplant Group found that nearly 28,000 deceased-donor kidneys in the US went unused between 2004 and 2014.

According to the HRSA, the decision to end UNOS’s leadership role is meant to open a competitive bidding process by dividing the functions of UNOS so that multiple bidders can address different transplant-related tasks independently, with HRSA oversight.