Global Liver Institute Applauds HRSA’s Announcement of OPTN Modernization Initiative and Contract Break Up as Critical to Achieve Health Equity


Global Liver Institute commends Health Resources and Services Administration (HRSA)’s recent announcement that it will break up the Organ Procurement and Transplantation Network (OPTN) monopoly in order to improve accountability and transparency in the organ donation system. The OPTN contract has been held exclusively by the United Network for Organ Sharing for the duration of its existence (nearly 40 years). Last week’s announcement follows a bipartisan report from the Senate Finance Committee that found that “From the top down, the U.S. transplant network is not working, putting Americans’ lives at risk. Specifically, HRSA will solicit multiple contracts to facilitate competition and improvements, “particularly with respect to information technology vendors”. Additionally, a data dashboard was released detailing information like organ retrieval and waitlist outcomes.

For the 100,000 people in the US currently waiting for a transplant, especially those most at risk, these changes are long overdue. Issues of organs going missing and mischaracterized data have drawn attention in the past. Even in the past week, a thorough analysis following a change in rules in 2020, originally intended to prioritize the sickest patients, has since caused a distinct drop in liver transplantation in regions with high rates of death due to liver disease, including the South, Midwest, and Puerto Rico, in favor of higher-income areas. National leaders, including Al Gore, a co-sponsor of the National Organ Transplantation Act of 1984, have recognized the need to modernize the OPTN system in a competitive environment as critical to equity.

“Where you live should not determine if you live,” states Donna R. Cryer, JD, GLI CEO and President. “This investment in accountability and transparency in our national transplant system is a critical and long-awaited step for patients and their families across our nation. It isn’t about lists. It’s about lives.”

The contract to operate the OPTN is paid for primarily by the listing fees of patients in need of a lifesaving transplant. Each organ wasted reflects disregard for donors, recipients, and their families. We will not continue to accept the misuse and mismanagement of both taxpayer funds and of donors’ gifts.