What does Biden's overhaul of the Organ Transplant System mean for kidney patients?

The Biden Administration Plans To Overhaul The Organ Transplant System

An estimated 104,000 people are on the organ transplant list in the United States and 17 people die every day waiting for a transplant. Even with a record of 42,888 transplants completed last year, it is not nearly enough to keep up with the demand. Thousands of people on the waiting list die each year.

On Wednesday, the Biden Administration outlined a plan to overhaul the nation’s current organ transplant system, “to break up the system that historically allocated kidneys, livers and other organs to patients.” All in an effort to save more lives. The current system is ineffective and usually benefits different groups of people by race and geographical location.

Up until now, the non-profit United Network for Organ Sharing (UNOS) has had the only contract for managing the transplant system. “Audits and a congressional probe have chronicled problems including long wait times, inequities in allocations, failing IT infrastructure, and even organs lost in transit.” The current system is outdated and a new program would enable patients to be more empowered to take control of their transplant journey.

"We've got to be able to get organs from donors to recipients in a more fluid, efficient way," said Dr. David Mulligan, a transplant surgeon and immunologist in the Department of Surgery at Yale School of Medicine in New Haven, Connecticut. The new plan would provide patients with more timely information, address equity, give care and treatment options on-time and offer referrals to overlooked patients.

The UNOS group “has been blamed by U.S. lawmakers and other outside groups for not adequately managing the nation's transplant and organ procurement centers, which has resulted in damaged organs and delays that led to unsuccessful transplants.” UNOS has run the program for nearly four decades. This includes, “overseeing the groups that retrieve organs, helping set policies for how organs are distributed and patients are prioritized, and running the massive computer system that matches organs with patients.”

The Health Resources and Services Administration (HRSA) announced it will attempt to broaden and modernize the transplantation system. It aims to end the UNOS monopoly and divide duties between more than one group. Also on Wednesday, the HRSA opened a new website designed to help patients easily understand organ donation and transplantation (see HERE).

The HRSA’s plan for the Organ Procurement and Transplantation Network (OPTN):

• A data dashboard that details: organ retrieval, waitlist outcomes and transplants.
• Modernize the network’s IT infrastructure.
• More overall transparency and accountability.

The Biden administration is requesting $67 million in the fiscal 2024 budget–more than double the fiscal 2023 allocation of $36 million.