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Embracing transformation

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Embracing transformation

McBride’s opening remarks to the OPTN Board of Directors at the biannual in-person meeting

The Organ Procurement and Transplantation Network (OPTN) Board gathered in person in December 2023 to discuss new policy proposals and focus areas for continuing its work to strengthen the organ donation and transplant system. Maureen McBride, Ph.D.— who serves as the CEO of UNOS, the OPTN contractor, as well as the Executive Director of the OPTN—provided the following opening remarks to the OPTN Board of Directors at the biannual in-person meeting:

Maureen McBride, UNOS CEO

“We know why we must transform: we must do it on behalf of the people who gave the gift of life and the patients who depend on the lifesaving gift of an organ.”

Maureen McBride, Ph.D., CEO of UNOS and Executive Director of the OPTN

Good morning, everyone,

Six months ago, I stood before you to acknowledge the era of enormous change in which this community finds itself – and to advocate for working together to embrace it.

Of course, you responded with resounding support. This community always responds. It’s who we are – a collaborative network that has been devoted, since its inception, to fueling growth and innovation in the U.S. organ donation and transplantation system. We do it to realize, as quickly as possible, a future in which we honor the generosity of donors and donor families by ensuring more and more patients have access to lifesaving transplants.

We have a lot to show for our work this year and a lot to celebrate.

As we look ahead to 2024 and beyond, we should pause to recognize that we are at an inflection point in this community. We have the opportunity to not just embrace change but to ignite transformation.

I would argue that the OPTN has been seizing transformative opportunities for many years, and now as we face the future of changes within the OPTN and changes within the Organ Procurement Organization (OPO) community, we have more opportunities than ever before. We need to capitalize on these opportunities and make the most of them on behalf of the patients we serve. We can use this time to Reimagine. Reinvent. Redefine.

As you all know, in July, Congress passed the “Securing the U.S. Organ Procurement and Transplantation Network Act,” which President Biden signed in September.

This legislation changes the structure and funding of the OPTN for the first time since we were established almost 40 years ago. It gives HRSA the authority to issue multiple contracts to support this community’s lifesaving work. It also lifts the $7 million dollar appropriations cap on the OPTN contract. This lays the groundwork for additional OPTN funding from the government, which will help facilitate many more vital projects and initiatives developed by you, the experts who lead this field, in service of patients and donors and their families.

The Act will drive transformation in the way we operate. We all have supported and applauded the Act’s intent, which is to support OPTN efficiency, equity and accountability.

Importantly, the Securing the U.S. OPTN Act empowers our partners at HRSA to execute their OPTN Modernization Initiative first announced in March.

I want to address a report that has made its way to Capitol Hill: That the transplant community does not support the Modernization Initiative. This is not true. While we have many questions about the implementation of the initiative over the next few months, I think we all agree that the goal of the Modernization Initiative is to improve the OPTN overall. We are not trying to incite fear and hysteria that there will be dire outcomes for patients. Transformation is always hard, but it will be even harder if patients and others are made to fear change. We must embrace this transformation together.

But let’s take a step back and talk about what I believe is going to happen over the next several months. Today is December 4. The current OPTN contract that UNOS holds with HRSA expires on March 29, 2024. That is 116 days from now. HRSA has explained that their plan includes time for transition before launching into the true next generation initiatives which will likely take place more than a year from now.

As we understand it, HRSA may release transition RFPs during the month of December.  Presumably, these contracts will allow for a smooth transition of services that will not bring harm to any patients. We are all committed to making sure that happens.

As the OPTN Executive Director, I encourage each of you to ask questions and be curious about the changes that are ahead, but let’s not do anything as a community to create hysteria about dire outcomes for patients. As the leader of the current OPTN Contractor, we are ready to embrace these changes. We know our role will be different in the future, and we are okay with that, as long as we are doing what is right for the patients we serve.

This transition phase that we are about to enter into gives us the opportunity to continue transforming the transplantation space. We don’t need to wait for modernization or next generation contracts. And we haven’t been waiting.

The OPTN has implemented transformative changes in this community time and time again – and we will continue to do so.

  • In 2014, we implemented the kidney allocation system – changing kidney allocation dramatically.
  • In 2017, we implemented an innovative way to allocate organs to patients who needed simultaneous liver kidney transplants.
  • Also in 2017, we started to remove arbitrary geographic boundaries from the allocation systems for all organs – first by using concentric circles, and over time we are working towards transforming into continuous distribution.
  • But it’s not all about allocation, we’ve implemented enhancements to the way organs are labeled and packaged – do you remember handwriting donor IDs on labels before we implemented the TransNet system?
  • We’ve implemented predictive analytics for kidney to give you more information about the organs you are being offered for your patients.
  • We’ve also developed organ offer filters for kidney and we know that is already making a significant impact on the efficiency of the match system using these tools. Yesterday, the Executive Committee voted on a plan to bring basic organ offer functionality to all organs by June 2024.

 

All of these examples are case studies on how the OPTN community has come together to grow and evolve and respond to challenges.

We are all here for one purpose – to save lives. Now, we have an unprecedented opportunity to rapidly take this system to new heights of performance. We must take it and run with it. We owe it to all patients in the United States.

Our responsibility to usher in a new era of organ donation and transplant that ignites transformation is enormous.

I know this community is up for the challenge.

We know why we must transform: we must do it on behalf of the people who gave the gift of life and the patients who depend on the lifesaving gift of an organ.

Each of the initiatives we’re working on, considered separately, is a proactive response to the continuing need to change and grow. Taken together, they represent a transformative vision for the future of our community.

Ours can be a vision that catapults patient health and patient outcomes to new heights. And it represents a future that the OPTN is shaping today and realizing tomorrow.

Living it forward

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