Today’s hearing before the House Energy and Commerce Committee’s Oversight Subcommittee, titled “A Year Removed: Oversight of Securing the U.S. Organ Procurement and Transplantation Network Act Implementation,” purported to be focused on the Health Resources and Services Administration’s (HRSA) implementation of its OPTN Modernization Initiative and improving outcomes for patients.
Instead, several invited witnesses took the opportunity to make serious, unfounded allegations that have the potential to jeopardize confidence in our country’s donation and transplantation system. They continued to promulgate untruths and misunderstandings about the OPTN and how the United Network for Organ Sharing (UNOS) has operated it for decades, with oversight by HRSA.
Among the troubling accusations made at today’s hearing were instances of alleged malfeasance by hospital staff, surgeons, and organ procurement organizations. If true, UNOS reminds the public that such allegations must be reported to applicable government authorities and law enforcement for further investigation. The safety of patients is UNOS’ top priority. Our position is clear: Any concern that the health or safety of patients has been jeopardized must immediately be reported to the relevant authorities for full investigation. UNOS, as the OPTN contractor, has a toll-free line to report safety events. Reports may be made confidentially and require prompt investigation. OPTN bylaws prohibit retaliation against individuals who report patient safety events.
UNOS has been a leader in working with the organ donation and transplantation community across the country, fully supports the HRSA OPTN Modernization Initiative, and has worked with Congress to fund it. Under new UNOS leadership, the organization has led efforts to improve the system, which are identified in the UNOS Action Agenda. In collaboration with stakeholders and government officials, UNOS established its independent corporate Board of Directors on March 30, secured language in the Federal Aviation Administration (FAA) reauthorization to ensure organs can travel above wing instead of as cargo to ensure safe handling and care, and educated policymakers about the need to ensure OPTN has the authority to collect pre-waitlist data on patients to understand and address barriers to transplantation. UNOS has called for a federal tracking system for organs, increased patient empowerment tools to support patients’ choices regarding their transplantation care, and improvements to hospitals’ donor referral processes to organ procurement organizations. UNOS performs this advocacy consistent with our mission and outside of our work or funding as the OPTN contractor.
New leadership at UNOS continues to make changes that will ensure a strong future for the system. Since assuming the role of CEO in April 2023, Dr. Maureen McBride has decisively steered UNOS towards a future defined by innovation and improvement. Her leadership has been characterized by a commitment to transparency and accountability. To ensure continued successful outcomes for the system and for patients, it is imperative that all participants in the nation’s organ procurement and transplant community work together for the benefit of patients.
For decades, at HRSA’s selection through a competitive bid process, UNOS has served as the only contractor for the OPTN. The OPTN is governed by a board and committees made up of more than 1,000 volunteers who generously give their time on behalf of our nation’s system. UNOS has been regularly engaged with the House Energy & Commerce Committee and its Oversight & Investigations Subcommittee to provide detailed information about the operations of the OPTN.
As the OPTN contractor, we have leveraged data and advances in science and technology to continuously strengthen the system, increase the number of organs recovered and the number of transplants performed, and ensure patients across the nation have equitable access to transplant. UNOS employs a team of experienced biostatisticians and data scientists to support data-driven policy development and system innovation. Additionally, we have a collaborative working relationship with the Scientific Registry of Transplant Recipients (SRTR), which is contracted by HRSA to provide analytical support to the OPTN.
Last year, the OPTN facilitated another record year for organ transplants, with 46,632 transplants performed in 2023 thanks to the selfless and generous gifts from donors. In addition, 10,824 Black patients received transplants last year, more than any year prior. Last year marked the thirteenth consecutive year of record deceased donors. Additional milestones reached include:
- More than 16,000 individuals became deceased donors, making 39,679 deceased donor transplants possible. Nearly a 9% increase from 2022.
- There were 10,660 liver transplants performed in 2023- the most ever performed in a single year.
- There was a 30% increase from 2022 in donors aged 65 years and older, representing a greater acceptance by the transplant community and candidates to receive organs from more medically complex donors.
The increase in transplants in 2023 is the result of several initiatives that have helped increase equity and enhance patient access to transplants, which were driven by the organ donation and transplant community and HRSA.
The organ donation and transplant community’s commitment to continuous system improvement drives the year-over-year increases in the number of lifesaving and lifechanging transplants performed. These improvements are necessary to ensure that each of the more than 103,000 patients on the national waitlist can receive an organ transplant. UNOS agrees that some of these reforms could be informed by additional OPTN data collection. That is why clarification from HRSA was sought regarding the OPTN’s authority to collect “pre-waitlist data” to understand why certain patients do not end up on the waitlist, and that is why UNOS, as the OPTN contractor, is working diligently to implement the directive from HRSA to collect those data.
And while the work of the OPTN has improved and expanded each year with the support of UNOS and under the oversight of HRSA, there’s still more work to be done. UNOS supports efforts to increase transparency for patients, improve equity among donation and transplantation, increase the number of living donors and decrease the non-use of organs available for transplant.
UNOS has the experience and expertise to remain an integral part of the national system and continue driving improvements for patients. At its core, UNOS is a mission-driven non-profit organization that is patient-focused and centered on continuous improvement of the system to achieve the best results possible. UNOS remains committed to working with Congress, HRSA, and stakeholders to ensure that more lives are saved every year.
