Biden administration proposes overhaul of organ transplant system

On Wednesday, the Health Resources and Services Administration (HRSA), a division of the Department of Health and Human Services, announced plans to modernize the US organ transplant system. For 40 years, the United Network for Organ Sharing (UNOS) has held an exclusive contract to facilitate the retrieval, matching, and distribution of all transplanted organs, handling a record 43K transplants last year. 

Starting this fall, HRSA will split out contracts and open the bidding process up to competition, hoping to increase efficiency, accountability, and transparency. While the Biden administration has asked Congress to double the funding appropriated to HRSA for the transplant system, it has the authority to institute many of these changes without Congressional action. 

The Gist: The US organ transplant system has long received criticism from patients and providers.With over 100K Americans currently on organ transplant waiting lists, and 6K dying annually while waiting (a group that is disproportionately Black and Latino), there’s vast room for improvement.

The government’s efforts to increase competition to solve operational and distribution challenges is overdue, but other aspects of the transplant process, including performance evaluation, deserve reassessment as well. For example, providers are scored on the survival rates of patients who receive transplants, but not those who die on waiting lists. Thus, they are disincentivized to operate on higher-risk patients or utilize organs that are potentially transplantable but have imperfections.

Hospitals and transplant specialists must take an active role in ensuring the overhauled process provides comprehensive reform, driven by the best interests of patients. 

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