The Health Resources and Services Administration has awarded new contracts to multiple vendors for the nation's organ transplant system, ending decades of reliance on the United Network for Organ Sharing as its sole contractor.
Seven notes:
1. The agency, part of HHS, announced new contracts with five vendors on Sept. 19:
- Arbor Research Collaborative for Health will oversee compliance and patient safety for the Organ Procurement and Transplantation Network.
- General Dynamics Information Technology will work to upgrade the technology used to match organs to patients and assist with future IT plans.
- Maximus Federal will help boost transparency and public involvement in OPTN policy-making processes.
- Deloitte will focus on improving internal and external communications for the transplant network.
- Guidehouse Digital will help modernize the network's budget development and management systems.
2. HRSA said the transition away from UNOS as its sole vendor will help improve transparency, performance and oversight of the network, ending the nonprofit organization's nearly four-decade "contract monopoly."
3. In August, HRSA also established an independent board to oversee the OPTN, separate from UNOS.
4. In recent years, UNOS has faced scrutiny about its management of the OPTN, with critics arguing that inefficiencies, oversight failures and a lack of accountability have jeopardized patient safety and contributed to organ nonuse. At present, more than 100,000 Americans are on the organ transplant waiting list.
5. In response to recent scrutiny, UNOS has defended its operations and disputed the characterization of its role as a "monopoly." The national nonprofit said it was awarded its long-standing contract with the government through a "competitive bid process."
"The fact that there has only ever been a single OPTN contractor is because the law — not UNOS — said there could only be one OPTN contractor," the organization said in a Sept. 13 statement on its website. "Use of the term 'monopoly' suggests that there is (or should be) a 'market' for organ donation and transplant in America — a position with which UNOS strongly disagrees."
6. UNOS said it has made significant strides under new leadership, including improvements in transparency and accountability, and successfully facilitated a record number of transplants in 2023. The organization also expressed its support for the transplant network's modernization.
"UNOS has been a leader in working with the organ donation and transplantation community across the country, fully supports the HRSA OPTN modernization initiative, and has worked with Congress to fund it," the organization said in an Aug. 29 release.
7. The Association of Organ Procurement Organizations said HRSA's announcement leaves key questions unanswered about the transition to the multi-vendor model, including when the new contracts will begin and what metrics of success contractors will be held accountable for.
"It will be critical that the transition does not impact in any way the ability of the current system to save lives through organ donation," the group said in a Sept. 20 statement.
The association is urging HRSA "to ensure that, as profit-driven companies assume oversight of critical elements of the system, including organ matching, patient communication and policy setting, transplant patients and donor families remain the priority of all decision making."
Editor's note: This article was updated Sept. 25 at 2:00 p.m. CT.