The federal government on Wednesday outlined a plan to reform the country’s organ transplant system, which has been plagued by problems including damaged or discarded organs and long waiting times.
According to the Health Resources and Services Administration, an agency within the Department of Health and Human Services, approximately 104,000 people in the United States are on the waiting list for an organ transplant. Seventeen people die every day while waiting for an organ transplant.
The current system, experts say, is ineffective and typically benefits affluent white men who have the means to travel to where organs are available.
“There are many problems that need to be addressed,” said Dr. Stuart Nechtl said. “It is clear that different groups of people are served differently based on race and geographic location.”
Dr. David Mulligan, transplant surgeon and immunologist in the department of surgery at Yale School of Medicine in New Haven, Connecticut, has been trying to reform the system for more than a decade.
“We need to be able to get organs from donors to recipients in a more fluid, efficient way,” he said.
The plan – outlined in a release by the HRSA – would nearly double the amount of funding the government agency receives from the US to $67 million in fiscal year 2024 to “modernize” the country’s transplant system.
Knechtle said the current system, based on a model from the 1980s, is out of date. A new program will provide patients with more timely information, helping them have more control over the transplant journey, he said. It will also help address issues of equity, where people who should be referred for transplant are overlooked or accessed care too late.
The US government will be offloading some of the responsibilities performed by the United Network for Organ Sharing to other outside organizations, commonly referred to as UNOS.
UNOS, a non-profit organization based in Richmond, Virginia, has been the sole manager of the nation’s organ transplant system since 1986, when the federal government awarded the group a contract. The group essentially operated as a monopoly, overseeing the system that donates organs to critically ill patients.
Mulligan said the group has been blamed by US lawmakers and other outside groups for not adequately managing the country’s transplant and organ procurement centers, resulting in damaged organs and delays that have led to failed transplants, He said he thinks some of the criticisms are unfair.
The idea of dividing responsibility is to allow more collaboration, Mulligan said, which could make the system more efficient and save more lives.
UNOS did not immediately respond to a request for comment.
The government’s plan would create an independent board of directors as well as an online dashboard that would give the public more information, including organ retrieval, waiting list results and demographic data on recipients.
“This move will instill transparency and accountability in the system,” HRSA Administrator Carol Johnson said in a statement.
“Every day, patients and families across the United States rely on the Organ Procurement and Transplant Network to save the lives of their loved ones experiencing organ failure,” Johnson said.
Knechtle said he was “eager” for change.
“I think there has been a lot of criticism of the system. And we agree with those criticisms,” he said.
In January, UNOS proposed its own series of reforms to improve the organ transplant system, including creating new tools that would help patients better navigate the donation and transplant process.