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The U.S. Department of Health and Human Services (HHS) has proposed organ procurement organization (OPO) reforms that will help thousands more patients access organ transplants. We have a time-sensitive ask for Members of Congress to sign on to a letter requesting that HHS Secretary Azar finalize the proposed rules that would hold OPOs more accountable and require verifiable compliance with standards already in place.

Take Action

As a patient or liver health advocate, please urge your Congress member to sign on to the letter today. The deadline for Members to sign-on is close of business 8/26/2020.

Read the Letter


What is an OPO 

An organ procurement organization (OPO) is a non-profit organization that is responsible for the evaluation and procurement of deceased-donor organs for organ transplantation. There are 58 such organizations in the United States, each responsible for organ procurement in a specific region, The individual OPOs represent the front-line of organ procurement, having direct contact with the hospital and the family of the donor.

There are good and bad actors in any industry, and many OPO professionals are doing great work. However, OPOs have become an industry in which bad behavior persists unpoliced, in large part because people presume that professionals who do good work are all doing it well. It is literally a matter of life and death to know which OPOs are doing well and which are under performing. Our goal has never been to hinder their ability to operate only that they be held to objective metrics for accountability.

The Problem 

The government monopoly contractors (OPOs) who run the organ donation systems are massively underperforming according to a December 2019 HHS proposed rule, which found more than half of OPOs out of compliance with proposed objective standards. Amidst all this – no OPO has lost a government contract in decades. Not all deaths medically qualify for organ donation, but OPOs are expected to recover a certain percentage of those deaths in order to maintain their government contracts. In practice, however, OPOs self-interpret and self-report their performance data, a dynamic almost unheard of in healthcare.

  • OPOs report performing far better than objective data shows. Research found that while OPOs report recovering between 70-80% of potential organ donors, the real number is closer to 35%.
  • Reforming the organ donation system could lead to 28,000 additional lifesaving transplants and save $12B over 5 years to Medicare
  • If these changes were to take effect, waiting lists for Liver Transplants could be greatly reduced
  • 33 Americans die every day due to lack of an available organ for transplant. And with 95% of Americans supporting organ donation, more Americans would have a chance at a life-saving organ transplant if the government contractors on the frontline of coordinating donation – organ procurement organizations (OPOs) – were doing their jobs effectively.
  • OPO contracts, though ostensibly nonprofit, are enormously lucrative, with OPOs reimbursed for 100 percent of all costs. CEO salaries can go as high as $1.5 million, and reporting has found wasteful spending on parties, retreats, private planes, and excessive compensation for family members of OPO management.

For more information, see Responses to misleading claims from the Association of Organ Procurement Organizations (AOPO)