UNOS faces House scrutiny: 9 things to know

At the House Energy and Commerce Subcommittee on Oversight and Investigations on Sept. 11, Rep. Morgan Griffith, chair of the subcommittee, called the United Network for Organ Sharing's 38-year operation of the Organ Procurement and Transplantation Network a "monopoly."

The hearing was held to assess progress made from the 2023 U.S. Organ Procurement and Transplantation Network Act, which aimed to overhaul the country's organ transplant system.

The United Network for Organ Sharing, a nonprofit organization, has been the sole operator of the OPTN since 1986 under contract with the federal government. Richard Formica, MD, from Yale New Haven (Conn.) Hospital, serves as president of OPTN.

Here are nine things to know from the hearing:

1. Before the U.S. Organ Procurement and Transplantation Network Act in 2023, the board of directors for the OPTN and UNOS were the same. The Health Resources and Services Administration recently separated the OPTN board of directors from the UNOS board as part of the agency's OPTN Modernization Initiative, according to an Aug. 29 news release.
   
   
2. Some members of the new OPTN board previously served on the UNOS board, the Richmond Times Dispatch reported Sept. 12.
   
   
3. Mr. Griffith was critical of UNOS in his remarks, referencing "inefficiencies" and "failures" in its oversight of the OPTN and the 56 organ procurement organizations operating within the network:
   
   "The lack of accountability must be addressed to create a more stable and reliable system," he said. "If we can track our Amazon order for socks … we should be able to track something as valuable as human organs."
   
   
4. House Energy and Commerce Committee Chair Cathy McMorris Rodgers was similarly critical: "Changing the name of the governing bodies of the OPTN but keeping the same individuals in place who failed to provide true oversight in the past is unacceptable," she said. "Their inefficiencies and lack of accountability have cost people their lives."
   
   
5. Representatives from HRSA and OPTN were invited to the hearing but did not attend.
   
   
6. UNOS responded to the hearing in a Sept. 11 news release, calling claims made at the hearing "serious" and "unfounded," and adding that the claims "have the potential to jeopardize confidence in our country's donation and transplantation system."
   
   
7. UNOS also said it "fully supports the HRSA OPTN Modernization Initiative and has worked with Congress to fund it."
   
   
8. Responding to claims of a monopoly, UNOS said it has been awarded its contract with the government through a "competitive bid process."
   
   
9. UNOS said Dr. Formica did not attend the hearing because he "is a practicing physician who was informed of the hearing with little notice."
   
   

Editor's Note: This story was updated on Sept. 16 at 8:45 am CST to clarify that Dr. Formica is president of OPTN not UNOS and that representatives from UNOS were not invited to the hearing.