Enable OPOs to merge or share services to boost their ability to serve hospitals and patients


Automate real-time donor referral

Establish better metrics

Get the right organ to the right patient

Remove disincentives

Enable OPOs to merge or share services

Save even more lives

The U.S. has the highest performing donation and transplant system in the world. But as good as it is, it needs to get even better to support the more than 100,000 patients on the waiting list. Based on the input of experts in our field, UNOS is proposing a five-part package of reforms to drive improvements to save even more lives.


CMS’ proposed rule provides no detailed transition plan addressing infrastructure in the service area of a decertified OPO, which could lead to ongoing disruption in parts of the country. Replacement organizations would need to rebuild the relationships and public trust necessary to maximize local organ procurement and distribution. Regulations that expedited or incentivized voluntary mergers among OPOs could expand the reach of effective OPO leadership without creating the risk of gaps in the organ recovery network.


Provide regulatory mechanisms for OPOs to more easily merge, or pool, services and prevent regions of the country from losing organ procurement services because their OPOs were decertified.


CMS should revise its regulations and create an expedited process for reviewing and approving a change in ownership when currently certified OPOs are involved. CMS also should remove barriers to sharing resources. And it should provide incentives for OPOs to merge by extending an OPO’s certification cycle if its performance in the newly merged service area of a formerly lower performing OPO improves by a certain percentage in the first two years after enactment of the new regulation.



Insights from UNOS leaders on key issues in transplant today

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Benefits of OPOs merging or sharing services

  • Prevent disruptions to transplant services arising from decertification without any appropriate replacement.
  • Reduce business inefficiencies and strengthen existing resources and services.
  • Support OPOs in need of assistance and improve performance of the system overall.


Overview of the 5 ways collaborative reform package

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