US Has One Organ Transplant Overseer. That Could Change

Just one entity has been at the reins of the US transplant system for nearly 40 years, a fact the Biden administration is gunning to change. The government on Wednesday proposed breaking up the contract to oversee organ transplantation, which would take the sole responsibility for doing so out of the hands of the nonprofit United Network for Organ Sharing, or UNOS. The first federal contract to manage US organ transplantation was doled out in 1986; UNOS won it, and has won it every time since. Its current contract is up this year. More on the development:

• Why the change now? UNOS has been on the receiving end of criticism for years and things came to a head with a Senate Finance Committee investigation. The major criticisms, per Richmond.com: that "UNOS's software is out of date, the number of transplanted organs falls short of expectation, and that UNOS failed to discipline its struggling member organizations."
• Elaborating on that. The Washington Post details other problems that have occurred under UNOS' supervision: "Too many organs are discarded, damaged in transit or simply not collected, faulty technology sometimes jeopardizes transplants, and poor performers face little accountability."
• The unmet need. The AP reports that while there was a record 42,888 transplants last year, the demand remains significantly greater, with more than 100,000 patients are on the national transplant list; thousands die while waiting.
• But... The AP notes the administration's moves don't directly target some of the problems the Post outlined, like organs that could be collected but aren't, or hospitals that opt not to use organs that aren't in pristine condition. Some have pushed the government to establish performance goals around thorny issues like those.
• The recommendations. The Senate Finance Committee suggested the contract be divided into five parts to bring competition into the equation: policy development, compliance, patient safety monitoring, IT infrastructure, and logistics. The number of contracts has yet to be confirmed by the Health Resources and Services Administration, which oversees UNOS.
• UNOS' reaction. The nonprofit detailed improvements it planned to make in January and had this to say in a Wednesday statement: "We believe we have the experience and expertise required to best serve the nation’s patients and to help implement HRSA's proposed initiatives."

(More organ transplants stories.)