70 deaths linked to the Organ Transplant and Procurement Network, prompting reform

By Stephanie Srakocic | Fact-checked by Jessica Wrubel
Published April 13, 2023

Key Takeaways

  • Organ Transplant and Procurement Network (OTPN) has faced criticism for issues such as lack of transparency, poor handling of donated organs, racial inequalities, and long wait times.

  • The Department of Health and Human Services Health Resources and Service Administration Branch announced an overhaul and modernization of the system to correct these issues.

The Organ Transplant and Procurement Network (OTPN) is set to see modernization and improvement over the next couple of years after the network was criticized for lack of transparency, long waits, the mishandling of organs, and the number of people who die on the waitlist each year.

In March, the Health Resources and Services Administration (HRSA), an agency of the US Department of Health and Human Services (HHS), announced the launch of the OTPN modernization project.[] Until now, the OTPN has been exclusively managed by the nonprofit United Network for Organ Sharing. The new HRSA initiative will focus on accountability.

 Modernizing organ donation

The current OTPN system is outdated and the regulations that govern contraction and appropriations for organ transplants are decades old. A 2022 senate report found that errors in the OTPN system were responsible for 70 deaths between 2010 and 2020.[] These serious issues are part of why the Biden Administration and the HRSA have committed to modernizing the system. The 2024 presidential budget includes increased funding for organ transplants and procurement, a total of $67 million, up from $36 million in 2023. 

With this increased funding, HRSA plans to take steps, such as creating a new dashboard for the ONTP.

This dashboard will provide information, such as the locations and details of organ donation centers around the country, along with information about organ retrieval, waitlist outcomes, and demographic data about transplant donors and recipients.

The HRSA hopes this new transparency will better serve patients and their families. Maria Rodriguez, MD, an obstetrician and gynecologist in San Jose, California, says this change has been a long time coming.

“The transplant system we’ve been relying on for nearly 40 years is outdated. Not to mention, the software has periodic system failures, mistakes in programming, and overreliance on manual input of data,” says Rodriguez.

Additional modernization will focus on overhauling the operations of the OTPN system to ensure higher compliance and a greater focus on patient safety. These new measures aim to improve the overall quality of the OTPN system, creating better results for the 100,00 Americans currently awaiting an organ transplant. Patient needs are a primary priority for the HRSA modernization effort. 

“This change benefits the patients so much, and it’s what they really need. There are plenty of individuals and families relying on this life-saving system and it’s only right to put more effort into it,” Rodriguez says. 

Addressing inequality

In the United States, organ transplants, along with concerns about the ONTP, are issues that disproportionally affect the Black community.[] According to statistics, about 13% of the country’s total population is Black Americans, but about around 30% of the ONTP waitlist is Black Americans. In this group, about 90% are waiting for kidney transplants. 

Factors such as socioeconomic trends and racism within the healthcare industry contribute to keeping this large percentage of people in need of transplants on the waitlist for longer than people in other racial groups. Changes to the ONTP can help address this type of inequality by improving accountability, transparency, and systems of organ retrieval and matching.  

What physicians need to know

“Plenty of patients have died waiting for their turn and a lot of surgeons have lost hope for their patients,” says Rodriguez. “With over 100,000 people waiting for their organ transplants and an average of 6,000 people dying annually while waiting, it’s highly critical to support their needs as soon as possible."

Better management and distribution of donated organs to prevent such a high percentage from being discarded is something HRSA’s plan hopes to address.

Although it is still too early to say how effective the system modernization and new operations will be, this is the biggest change to the ONTP in decades. The HRSA is committed to ensuring that these changes result in improvement. In the near future, physicians might be able to see more of their patients receive the life-saving transplants they need.

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