U.S. Organ Transplant System, Troubled by Long Wait Times, Faces an Overhaul

WASHINGTON — The Biden administration announced on Wednesday that it seeks to break up the network that has long run the nation’s organ transplant system, as part of a broader modernization effort intended to shorten wait times and reduce the number of patients who die while waiting.

More than 100,000 people in the United States are awaiting organ transplants in a system that has long been defined by an imbalance between supply and demand. Patients sometimes wait years for donated organs, and people die each day. This is not the first reform effort; 25 years ago, the Clinton administration tried its own modernization initiative.

For nearly four decades, the system has been run by the United Network for Organ Sharing, a national nonprofit known as UNOS that, under contract with the federal government, coordinates the work of transplant hospitals and organ procurement organizations to match transplant candidates with donated organs.

Critics have long said the system is ineffective and disadvantages poor patients who do not have the means to travel. Federal officials say the computer system that does the matching is outdated.

The Biden administration is now putting the network out to bid, hoping to foster competition in a system that has effectively operated as a monopoly. Federal officials say they are open to having multiple networks operating across the country.

Officials also want to end a current practice in which members of the UNOS board sit on the Organ Procurement and Transplantation Network’s board, a panel of industry experts established by Congress to determine policies regarding organ transplantation. Officials view that as a conflict of interest.

The administration is also rolling out a website that will, for the first time, provide detailed, de-identified data on transplant wait lists, donors and recipients. The site will also include outcomes for individual hospitals to help patients and their families make decisions about where to seek care. The moves were reported earlier by The Washington Post.

“Every day, patients and families across the United States rely on the Organ Procurement and Transplantation Network to save the lives of their loved ones who experience organ failure,” Carole Johnson, the administrator of the Health Resources and Services Administration, the branch of the Department of Health and Human Services that oversees the transplant system, said in a statement.

She said the overhaul was intended to “bring greater transparency to the system and to reform and modernize” the network, adding, “The individuals and families that depend on this lifesaving work deserve no less.”