HRSA Announces Plans to Overhaul Organ Procurement Transplant Network

On March 22, 2023, the United States Health Resources and Services Administration (HRSA), a subset of the HHS, announced plans to overhaul the Organ Procurement and Transplant Network (OPTN). Recently, the transplant system has been criticized for failing to support patients properly and track organs.

According to the press release, the OTPN includes almost 400 organizations, leaving over 100,000 people on the waitlist for an organ. Despite valiant efforts by physicians, the system is imperfect, unfairly discriminating against patients by socioeconomic status, race, and gender.

Data from the National Foundation for Transplants notes that, currently, patients are expected to provide proof that they can cover 20% of transplant costs for amounts ranging from $69,400 to $276,480. Although insurance coverage and actual charges may vary, the price alone poses a barrier.

Beyond financial difficulties, data has proven that there are transplant inequities based on race, with Black patients being 25% less likely to be on the transplant list than White patients. Additional data notes that gender inequities, such as the perception of children as liabilities for women but not men, persisted. 

The new proposal, the OPTN Modernization Initiative, aims to enhance system accountability, equity, and performance. The primary goals include improvement in technology, data transparency, analytics, governance, operations, quality improvement, and innovation.

One of the primary goals of the HRSA is to continue improving the OPTN IT system. Although the HRSA acknowledges that the IT system is relatively sound, the organization hopes to increase functionality and security.

Beyond technology, the initiative also hopes to enhance data transparency and analytics. To improve decision-making for providers and patients, the HRSA plans to evaluate the existing analytical system, enforce better oversight and compliance, and enhance scientific research with robust data.

Additional goals include curating a diverse board of directors that can provide well-rounded opinions and new perspectives when developing and enforcing policy.

Following reports of organs lost in transport, new HRSA goals hope to mitigate the risk of organ transport complications.

“Members of the transplant community have had organs miss the connection and stay in the holding area because nobody knew exactly where it was supposed to go. There have been situations where nobody knew exactly where the organ was until several hours later when it was found in holding. And again, these aren’t soybeans that can go whenever and wherever people want. These have a defined life span for the most part,” Bobby Nibhanupudy, MD, medical director of the abdominal transplant program at AdventHealth, and the medical director of the Organ Procurement Organization (OPO), told LifeSciencesIntelligence in an interview in 2022.  

Other operations goals include improving patient safety monitoring, providing member support, and enhancing patient and family education efforts.

The press release also outlines steps the HRSA plans to take moving forward, including the following:

• improving data transparency for informed decisions
• securing support for the initiative
• consulting with the United States Digital Service
• engaging diverse stakeholders
• collaboration with the IT community

As the HRSA continues to develop and implement the modernization initiative, clinicians, OPOs, and patients awaiting transplants will watch, hoping for a new and effective system.