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UNOS advances plan to restructure transplant network governance to best serve patients

January 10, 2023, Richmond, VA

United Network for Organ Sharing (UNOS), the mission-driven non-profit that serves as the nation’s Organ Procurement and Transplantation Network (OPTN), has recommended a plan to the Health Resources and Services Administration (HRSA) to restructure the two organizations’ respective boards of directors and establish the OPTN as an independent non-profit entity. The move is intended to increase autonomy and transparency to better serve the nation’s transplant patients.

In a letter sent today to HRSA Administrator Carole Johnson, UNOS leadership requested HRSA’s approval of a proposed modification to the organization’s contract with the federal government that would establish two distinct boards of directors for UNOS and the OPTN. Separating the boards would require the establishment of OPTN as an independent, nonprofit entity.

UNOS Board President Dr. Jerry McCauley, Vice President Dr. Dianne LaPointe Rudow, Past President Dr. Matt Cooper, Vice President of Patient and Donor Affairs Valinda L. Jones and UNOS Interim CEO Dr. Maureen McBride authored the letter.

“It is critical that key areas of authority, responsibility and accountability between and among HRSA, the OPTN, and the OPTN contractor be definitively established to ensure an effective governance model for the benefit of the patients, donors and donor families we serve,” wrote McCauley, Rudow, Cooper, Jones and McBride.

Since the formation of the OPTN, the OPTN and UNOS have used a unitary board approach, wherein the UNOS Board serves as the OPTN Board. This is done in compliance with the National Organ Transplant Act (NOTA), its enabling regulation and the current OPTN contract that is held by UNOS. However, with the evolution of the U.S. organ donation and transplantation system, UNOS, HRSA, regulators, and members of Congress have determined that transplant patients will be best served if the OPTN and its Board were given greater independence.

UNOS first initiated discussions with HRSA about the process of developing an independent OPTN in May 2021. As the federal administrator that oversees the OPTN contract, HRSA is essential to endorse the proposed restructuring.

“We respectfully request that HRSA approve this modification quickly, as separating the boards raises many complex questions and will require extensive collaboration to ensure a seamless transition for our community,” wrote McCauley, Rudow, Cooper, Jones and McBride. “The end of the current contract, September 29, 2023, would be an ideal time to complete the separation of the boards.”

This is the latest in a series of actions by UNOS to further improve the U.S. organ donation and transplant system. During an OPTN Board of Directors meeting on December 5, 2022, UNOS leadership called for the donation and transplant community to expand upon ongoing improvements to the system, which achieved a world record number of annual transplants in 2021 and 2022 and recently performed the one millionth U.S. organ transplant in 2022. In the days following the meeting, UNOS has engaged with the U.S. Department of Transportation, the Centers for Medicare & Medicaid Services (CMS), the U.S. Digital Service and other public and private stakeholders in the pursuit of this goal.

A copy of the full letter can be found here.

Saving lives together

UNOS is a nonprofit organization with decades of experience in helping save lives through research, technology, innovation and education.

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TOPIC | Improvement
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