Civic Register
| 5.4.21
House Committee Holds Hearing on Reforming America’s ‘Grossly Inefficient’ Organ Transplant System
Should there be reforms to the U.S. organ transplant system?
What’s the story?
- The House Oversight Committee’s Subcommittee on Economic and Consumer Policy held a virtual hearing Tuesday to examine the U.S. organ transplant system and reforms that are moving forward. The hearing ― titled “The Urgent Need to Reform the Organ Transplantation System to Secure More Organs for Waiting, Ailing, and Dying Patients” ― featured testimony from stakeholders including patients on a waitlist for a transplant, a doctor who is a living donor, and experts on the transplant system.
- There are 107,000 Americans on an organ transplant waitlist, 33 of whom pass away each day before a transplant becomes available. Additionally, there are hundreds of thousands of Americans who are undergoing dialysis and would benefit from a transplant but aren’t on a waitlist.
- Much of the hearing focused on the role played by the nation’s 57 non-profit Organ Procurement Organizations (OPOs), which are certified and regulated by the Centers for Medicare and Medicaid Services (CMS). OPOs are granted a monopoly over their designated region and focus on obtaining organs from deceased donors, which account for over 80% of transplants.
- One of the panelists, Dr. Dara Kass, is an emergency room doctor who served as a living donor to her young son, who suffered from a liver condition prior to receiving the transplant. Kass testified that both her personal and professional experiences underscored the need for OPO reform:
“We cannot overstate the urgency upon us in reforming the OPO system to ensure that it is functioning and accountable. As an ER doctor, I had repeatedly witnessed OPOs mismanage families, communicate poorly, and ultimately leave organ transplant patients languishing on the waiting list.”
- Matt Wadsworth, president and CEO of an OPO called Life Connection of Ohio, testified about the nature of the problems in the industry:
“As an industry, OPOs are grossly inefficient. For scale, peer-reviewed research finds that as many as 28,000 organs go untransplanted every year, with much of the problem owing to wildly variable OPO performance and severe, persistent failure at many OPOs which has gone completely unaddressed by regulatory bodies… As geographic monopolies, OPOs are not subject to any competitive pressures to provide high service, and as the only major program in all of healthcare 100% reimbursed for costs, we do not face financial pressures to allocate resources intelligently. OPOs are given blank checks and participation trophies as patients are given death sentences. It is truly hard to find a more important system with less accountability.”
- Chairman Raja Krishnamoorthi (D-IL) noted in his opening remarks that there have been some “disastrous” failures by OPOs:
“Kaiser Health found evidence of hundreds of organs delayed, damaged, or lost in transit. Last year, an OPO delivered lungs for transplant, but never tested a sample they collected for COVID. The lungs were infected with COVID, which killed the transplant patient. In another case involving two organs, the donor’s blood type was incorrectly identified ― tragically, one transplant recipient died, and the other was gravely injured.”
- Ranking Member Michael Cloud (R-TX) noted in his opening remarks that a recently finalized regulation will increase oversight of OPOs:
“In response to President Trump’s executive order calling for more reforms of the organ procurement system, the Centers for Medicare and Medicaid Services issued a final rule in December. After a brief pause from the Biden Administration and thanks to the chairman and the work of this committee, the Biden Administration, just about a month ago, reissued the rule. The rule aims to increase the performance standards for OPOs and threatens decertification for lackluster performance.”
- Under the rule, new performance and outcome measures for OPOs will be implemented starting in 2022, and OPOs will be accountable for the new measures for recertification purposes in 2026.
— Eric Revell
(Photo Credit: iStock.com / sturti)
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Government-subsidized monopolies are never a good thing, for the reasons stated above; in any vital service, they need to be avoided at all cost, lest the corruption innate to that system overcome the service and lead to death, suffering, and incalculable waste.
There is always a path to improving the organ transplant system. My son is waiting for a liver transplant the past 2 years.
There is need to change our entire healthcare system, let alone organ transplants. The need is high for streamlining and updating care.
Definately needs to be kept in non profit control
The concept that multiple autonomous entities can provide what is needed to maximize the saving of lives is flawed. A new efficient national system needs to be instated.
If there is any accountability & oversight for organ transplants I couldn't locate it. Found this out while trying to help someone find a way to fund a heart transplant for their son. Their son kept getting skipped over. By the time he was finally chosen, it was too late.
Unregulated monopolies have no accountability for poor performance. The organ transport system is essentially accountable to no-one and there are no consequences for inadequate performance. This is clearly a system that is failing many and in need of change. The easiest and most direct approach is doing the kind of things that the government can do and provide regulatory oversight and establish performance metrics which can be used to find best practices for the regional monopolies granted the authority to collect and accurately transport life saving organs to those in need.
I’m a kidney transplant patient myself, I had the operation done in mid-February 2020 (definitely not the best time to be newly immunosuppressed). My family was given a random call at around 3 PM on a Saturday afternoon, which we were told by my expansive nephrology team could potentially happen any day for about 2-3 months. After I’d done my time in the ICU and was begrudgingly allowed home, I was in and out of the hospital every 2 months, sometimes for a fortnight at a time, for the better part of a year. It took a very long time of in- and out-patient tests for them to realize that my donor had given me Epstein-Barr virus, the virus that causes mono. I was told to be grateful that I had it easy because the experiences of others had been far worse; my primary nephrologist, who after some years basically became my primary caregiver, actively warned me and my family of what people on dialysis had to live with. If my experience is supposed to be “the best you could ask for,” then I genuinely pity the thousands upon thousands of people that have had it much worse.
I am the sister of a heart recipient, the system used currently is killing people. Fix it.
Not sure. Need more info.
if Senator Collins cared she would champion it
it can't hurt to review it. Just as long as any new policy doesn't get in to the new trend for equity, systemic racism, political correctness - that all poisons the well with deciding based on what you look like instead of who is in most immediate danger of dying.
Position or wealth should not be involved in organ transplant system. No one should be allowed to buy a transplant just because they are rich. The prime list for transplants should be based on the immediate need of the individual.
Congresspersons, As your constituent, Kevin Shea, from 1489 Sound Avenue, Baiting Hollow, NY 11933, #NY01, and as a participant in the Kidney paired exchange program, I urge you to enable reform to the organ transplant system. Extend the lives of peopke and save money in our government.
Oh be real.. The left needs to divert "continually" from ridiculous spending, grabbing of our freedoms and their racism.. You know the part of Jim Crow; abortion clinics in poor neighborhoods, lousy schools -> Democrat policies. Biden Hunter; the Bidens in general, Clintons etc.. get rich in office - how does that happen eh? Democrats are not doing too well in the audits of voting machines and the recent special run-offs.. Actually, democrats you got destroyed by the vote. 2022 is approaching...
Improvement and accountability necessary.
Absolutely in 21st century we are so far behind in reforming specially life death situation with decade old system we must save lives with all means of resources available, thought human has enough scientific progress
I’m saying maybe because I don’t know enough about this topic to really be able to express an opinion. But I can say that reforms won’t do any good if the labor force is not up to the task. You can pass any legislation or reform but if you still have careless A holes who don’t give a damn about the quality of their work, and I do believe there is A LOT of that going on in this country, everywhere, nothing will change.
yes, too many good healthy parts get wasted and lost in the system.
I am a donor wife (husband became an organ donor 20 yrs ago, helping 6 people). From what I have learned from this experience, too many people have to wait too long for organs; and less sick people (like those on dialysis) also need help sooner, possibly to avoid that fate altogether.