The country's organ transplant system is being overhauled. What that means for Richmond-based UNOS.

UNOS organ transplant network accused of mismanagement of organ transportation
Posted at 3:22 PM, Sep 25, 2023
and last updated 2023-09-27 18:58:18-04

RICHMOND, Va. -- There could be big changes ahead for Richmond-based United Network for Organ Sharing (UNOS) and the way organ donations are handled in the United States.

President Joe Biden recently signed legislation (passed unanimously by Congress earlier this year) that will lead to the overhaul of the nation's organ transplant system.

The system, for its nearly 40-year existence, has only been run by UNOS.

"Everybody knows the system has been broken for years, with heartbreaking consequences," White House Press Secretary Karine Jean-Pierre said last Friday. "Now with the President's signature, we are taking significant steps to improve it."

Biden has signed off on unanimous bipartisan legislation to overhaul the nation's Organ Procurement and Transplantation Network (or OPTN).

"The law will break up the current monopoly system harnessing competition to allow [United States Department of Health and Human Services] to contract with the best entities to provide a more efficient system for the people it serves," Jean-Pierre said.

Over 104,000 Americans are on the waitlist for an organ (with 85% of them waiting for a kidney) and 6,000 people died in 2021 while waiting for a transplant.

In recent years, their management has faced scrutiny from the Senate Finance Committee -- which released a report criticizing several aspects including testing failures that resulted in deaths, out of date technology, and a lack of oversight of the companies that collect and transport organs.

“This is a banner day in the effort to improve the organ transplant system in the United States,” Sen. Ron Wyden (D - Oregon), one of the main sponsors of the bill, said about its signing. “For too long, thousands of families have had to watch a loved one struggle while waiting for an organ transplant because the system has been inefficient and unaccountable. With this law, that starts to change: there is going to be accountability, know-how, and improvements to the Organ Procurement and Transplantation Network so more Americans are connected with a life-saving transplant. I want to thank my bipartisan partners on the progress made so far and look forward to continuing our work to improve this system so it meets the high standard American families expect.”

“In my nearly two decades spent fighting for U.S. organ donation reforms, I’ve heard far too many stories of patients who have lost their lives due to negligence and abuse of the system. Today’s bill signing opens a new chapter in our nation’s organ donation system by addressing the many failures that have plagued the organ procurement network, with disastrous consequences. This law will help bring positive outcomes for thousands of patients, including the nearly 600 Iowans currently waiting to receive an organ transplant,” added Sen. Chuck Grassley (R - Iowa), another co-sponsor.

Critics said reform couldn't happen as the old law prevented others from bidding for the contract. The new law allows administration to be broken up into multiple contracts and the federal government already announced a modernization effort earlier this year.

"I'm relieved, I'm grateful. I am hopeful. This is transformational in terms of what is possible for patients," Jennifer Erickson, Senior Fellow with the Federation of American Scientists, said. "What patients are going to receive is a first-ever competitive cycle for all the different functions of the Organ Procurement and Transplantation Network and that's a great day."

Erickson, whose father died of organ failure and worked on the OPTN issue in the Obama Administration, said while the exact way the system will change is still being worked out, breaking up the sole contract is key.

"What I think everyone watching this would understand is monopolies are a terrible idea," she said. "They do not serve patients, they do not serve Americans across the country."

For its part, UNOS said they welcomed the legislation, supported a more competitive and open bidding process, and were committed to improving the system.

In a statement released Friday, UNOS said in part:

No organization knows the incredibly complex system and the transplant community as well as UNOS. As this law goes into effect, we look forward to taking part in the new bidding process and demonstrating how our expertise should remain an integral part of this system.

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