The Biden administration announced a major change to the nation’s organ transplant system, which has been monopolized for decades by the nonprofit United Network for Organ Sharing (UNOS).
The overhaul stems from years of complaints from patients, transplant surgeons and patient advocates, including grieveances regarding racial inequity, organs lost in transit and long wait times. The new federal plan, known as the Securing the U.S. Organ Procurement and Transplantation Network Act, would allow other organizations to bid to run the business of organ procurement and upgrade the existing computer system that matches patients and organs, according to Axios.
“The announcement to break up the national organ monopoly is a huge win for patients,” Jennifer Erickson, a senior fellow at the Federation of American Scientists who worked on organ donation policy under President Obama, told Axios.
More than 100,000 Americans are waiting for organ transplants, yet under the current UNOS system, created by Congress in 1984, only about 117 transplants occur daily. According to UNOS data, about 90,000 people are waiting for kidneys, about 11,000 are waiting for livers, about 3,400 are waiting for hearts and about 1,000 are waiting for lungs.
More than 6,000 people die each year while waiting for an organ, according to the Health Resources and Services Administration.
“If we had a fully effective system, we could actually fully service the waiting list for hearts, lungs and livers within a couple of years," Greg Segal, cofounder of Organize, a nonprofit patient advocacy group that aims to increase the number of transplantable organs, told Axios.
“The idea that there is meaningful competition to not only replace UNOS but ensure that any contractor or contractors that operate in this system understand there is true accountability for performance and always feel that pressure is crucial,” Segal added.
The bipartisan bill was led by Senator Chuck Grassley (R–Iowa) and Ron Wyden (D–Ore).
“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,” Grassley said in a statement. “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.”
Health officials warn about unresolved questions regarding funding for the new system. The Biden administration requested $67 million for the organ transplant system in the fiscal year 2024. Without proper funding, the government and contractors won’t be able to overhaul the system. The HRSA plans to solicit contract bids for the network later this fall.