Advocates hail approval of bill aimed at limiting waste of donated organs

By: - July 31, 2023 5:35 pm

An estimated 28,000 donated organs go unrecovered each year, a Senate Finance Committee report estimated in 2022. (Photo by Carol Yepes/Getty Images)

Advocates say lives will be saved by legislation led by Sen. Chuck Grassley to change the way organs are procured and transplanted.

Grassley’s bill, approved by Congress last week, awaits the president’s signature. It will break up a monopoly held by the same organization since 1986 and allow different organizations to participate in various aspects of organ transplantation.

Currently, the Organ Procurement and Transplantation Network is operated by the United Network for Organ Sharing under an exclusive contract with the U.S. Department of Health and Human Services.

That contract is set to expire Sept. 30. When it does, the legislation will allow for multiple contracts to be accepted, allowing different organizations to specialize in the various roles of organ procurement and transplantation such as health information technology (I.T.), logistics and patient safety, which was previously managed by one organization.

Jennifer Erickson, a senior fellow at the Federation of American Scientists and former organ donation policy lead in the Obama White House, said the new legislation, which passed both chambers in bipartisan fashion, will create an impact, whether people were aware of the issue or not.

“Ninety-five percent of Americans support it [organ donation], which is a phenomenal amount of goodwill,” Erickson said. “What I think would surprise and horrify so many of your readers to know is that that goodwill has not been matched by competent, effective care of both donors and the patients who rely on them.”

Erickson said an increase in competition will save lives by allowing multiple organizations to focus on different areas.

“Basically, what this legislation does is its Congress explicitly saying to HHS, break up that monopoly contract, remove anti-competitive restrictions,” Erickson said. “So for the first time ever, they can choose from the best in class in each field, so the best health I.T. organizations, the best logistics organizations, the best in patient safety, so that we’re in a situation where we aren’t seeing 30 of our neighbors die every day.”

A 2022 Senate Finance Committee report estimated 28,000 organs go unrecovered every year.

Erickson said UNOS has failed Americans and the wishes of their lost loved ones. 

“If you’re very good at health I.T. that doesn’t mean you’re great at logistics, or if you’re great at logistics, that doesn’t mean you’re great at patient safety,” Erickson said. “Those are fundamentally different skills. And so instead of one monopoly that fails at each of these functions, HHS is now able to break it up and then offer contracts to the best to the best in each of these fields.”

Brian Shepard, then-CEO of UNOS, said during an August 2022 Senate Finance Committee meeting that the contract rebid is “based on a competitive process.”

Although critics contest this statement, Shepard said at the same meeting, “We welcome this competitive process, and it has been our honor to serve the nation for over three decades. From UNOS’ inception as a mission-based non-profit and since we began serving as the federal contractor, we have never once taken this privilege lightly.”

Grassley accused the United Network for Organ Sharing of mismanagement earlier this year. 

“United Network for Organ Sharing’s monopoly over the U.S. organ donation system has been disastrous,” Grassley said in a May news release announcing the legislation, which has now passed both chambers. “Decades of corruption and mismanagement have left vulnerable patients to die on the waiting list while unused organs from generous American donors go to waste.”

Organ transplants by the numbers

Currently, more than 103,000 people are on the national transplant waiting list

17 people die each day waiting for an organ transplant

Every 10 minutes someone is added to the waitlist

In addition to allowing the Health Resources and Services Administration to award multiple contracts or cooperative agreements to support the organ network, the bill also removes the maximum amount of funding available for supporting the donation network, according to the bill’s summary.

“This bill’s passage is proof that bipartisanship still works in Washington,” Grassley said in a news release. “I’ve been grateful to have support from my colleagues on both sides of the aisle since I first began investigating the organ industry in 2005. At long last, Congress has succeeded in untangling years of deadly errors in the organ industry to give patients a better shot at lifesaving care and root out corruption. Americans in need of organ donations, especially rural residents and people of color, will be greatly benefited by these changes.”

The effort led by Grassley and Sen. Ron Wyden, a Democrat from Oregon received support from both parties and marks the beginning of a new era of competition in organ donation.

“This is the rarest of things in Washington DC, which is bipartisan legislation that will really affect people’s lives,” Erickson said. “It will save people’s lives.”

Grassley discussed the legislation in a Tweet:

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Jay Waagmeester
Jay Waagmeester

Jay is a former Iowa Capital Dispatch intern. Jay is based in Ames and is currently a senior majoring in journalism and marketing at Iowa State University. He has interned at New Century Press and contributed to the Iowa State Daily.