The shortage of donor organs to transplant in the United States remains critical. Despite organ transplant numbers continuing to trend upward, more than 104,000 people still await a transplant. Seventeen die each day waiting for a life-saving transplant.

In response to this critical shortage of donor organs, the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, announced a new Organ Procurement and Transplantation Network Modernization Initiative in March 2023 to strengthen the accountability and transparency in the Organ Procurement and Transplantation Network (OPTN).

The initiative has three key focuses:

1. The release of new organ donor and transplant data with data dashboards detailing individual transplant center and organ procurement organization data. This includes organ retrieval, waitlist outcomes, and transplants, and demographic data on organ donation and transplant.
2. To better serve the needs of patients and families the OPTN IT system would be modernized to meet industry-leading standards, improve OPTN governance and increase transparency, accountability, and performance in the organ donation and transplantation system. Five key areas will be specifically targeted. They are technology; data transparency; governance; operations; and quality improvement and innovation. Contract solicitations for multiple awards to manage and improve the OPTN would be issued to implement the plan.
3. Congress will be asked to make specific reforms in the National Organ Transplant Act. They would include:
   1. A proposal for the President’s Fiscal Year 2024 Budget to more than double investment in organ procurement and transplantation with a $36 million increase over Fiscal Year 2023 for a total of $67 million. This investment could significantly impact the availability of TransMedics Organ Care Systems (OCS™). OCS™ is the only FDA-approved technology for lung, heart, and liver transplantation procurement in the U.S. TransMedics systems keep organs in an environment and temperature that mimic the physiology of the human body during transport from a donor to a recipient. The systems thus allow donor organs to be maintained for longer periods of time prior to transplant than by the traditional maintenance on ice during transfer.
   2. The Fiscal Year 2024 Budget to update the nearly 40-year-old National Organ Transplant Act to remove the decades-old ceiling on the amount of appropriated funding that can be awarded to the statutorily required vendor(s) for the OPTN.
   3. It also requests that Congress expand the pool of eligible contract entities to enhance performance and innovation through increased competition, particularly with respect to information technology vendors.

To keep stakeholders informed about the Modernization Initiative and provide regular progress updates HRSA has created an OPTN Modernization Website at https://www.hrsa.gov/organ-procurement-transplantation-modernization.

In a statement issued on their website (https://unos.org/news/), the United Network for Organ Sharing (UNOS), the private, non-profit organization that manages the U.S. organ transplantation system, states its support of the HRSA plan to introduce additional reforms into the nation’s organ donation and transplantation system. They state, “We also stand united with HRSA in our shared goal to get as many donor organs as possible to patients in need while increasing accountability, transparency and oversight.” UNOS also notes that numerous components of HRSA’s plan align with their own new action agenda presented on January 30, 2023, to reflect the needs of the broader donation and transplant community.”

https://www.hrsa.gov/about/news/press-releases/organ-procurement-transplantation-network-modernization-initiative