Written by Melissa McQueen and Jen Lau
**There have been a lot of changes in our nation's transplant system in the past year. And there will continue to be more moving forward. We have heard concern from caregivers and patients. As Jen Lau is VP of Transplant Families and current OPTN Board of Directors member, and Melissa McQueen is President of Transplant Families and former OPTN Board of Director member, we thought we would give you just the facts.
The world of organ transplantation is a complex web of dedicated individuals and organizations, all working in concert to save lives. At the heart of this intricate system are several key players: HRSA, the OPTN, transplant contractors, transplant hospitals, and OPOs. Let's delve into their roles and how they collaborate to make transplantation possible.
HRSA: The Guiding Force
The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, provides oversight and funding for the nation's organ donation and transplantation system. HRSA's role includes:
Funding and Policy: HRSA provides financial support and sets the policy framework for organ donation and transplantation activities.
OPTN Oversight: HRSA contracts with a private, non-profit organization to operate the Organ Procurement and Transplantation Network (OPTN). For the past few decades, the United Network for Organ Sharing (UNOS) has served as the primary contractor for this role. However, with the recent advent of modernization efforts, this has been opened up to multiple contractors to encourage competition, innovation, and diversity within the system. This shift aims to enhance efficiency, transparency, and ultimately, improve patient outcomes.
OPTN: The Central Hub
The OPTN serves as the central network connecting all professionals and organizations involved in the U.S. donation and transplantation system. Its core functions include:
National Registry: Maintaining a national registry of patients awaiting organ transplants.
Matching Donors and Recipients: Developing and implementing policies for allocating organs fairly and efficiently.
Data Collection and Analysis: Collecting and analyzing data to improve the transplantation process.
Policy Development: Creating and updating policies related to organ donation, procurement, and transplantation.
Transplant Contractors: Operational Support
Transplant contractors, like UNOS (historically) and other organizations now involved in the modernized system, work under contract with HRSA to manage the OPTN. Their responsibilities encompass:
Operating the OPTN: Managing the day-to- day operations of the OPTN, including the national registry and organ matching system.
Implementing Policies: Putting OPTN policies into action and ensuring compliance.
Providing Support: Offering support and resources to transplant centers and OPOs.
** As of publication of this post UNOS is still supporting OPTN committees and regional meetings, American Institutes for Research (AIR) is supporting the OPTN Board.
Transplant Hospitals: Providing the Care
Transplant hospitals are medical centers equipped to perform organ transplantation surgeries. Their essential roles include:
Evaluating Candidates: Assessing potential transplant recipients to determine their eligibility.
Performing Transplants: Conducting the surgical procedures to transplant organs.
Post-Transplant Care: Providing ongoing medical care and support to transplant recipients.
OPOs: The Organ Recovery Heroes
Organ Procurement Organizations (OPOs) are non-profit organizations responsible for recovering organs from deceased donors. Their critical functions include:
Working with Hospitals: Collaborating with hospitals to identify potential organ donors.
Obtaining Consent: Securing consent from families for organ donation.
Organ Recovery and Preservation: Recovering and preserving organs for transplantation.
Matching and Transport: Working with the OPTN to match organs with recipients and ensure timely transport.
The Collaborative Network
These entities form an interdependent network, each playing a vital role in the success of organ transplantation:
OPOs recover organs and enter donor information into the OPTN system managed by the transplant contractor(s).
Transplant hospitals evaluate potential recipients and list them on the OPTN waitlist.
The OPTN, guided by HRSA policy, uses a complex matching system to allocate organs fairly.
OPOs then transport the organs to the appropriate transplant hospitals for surgery.
This intricate collaboration ensures that organs are allocated efficiently and equitably, giving hope and new life to thousands of patients each year.
Important Note Regarding HHS Communication Halt – January 21, 2025
It's important to be aware that a temporary halt to federal communication has been issued by the incoming administration. This includes all functions of the Department of Health and Human Services (HHS). While this communication pause is in effect and may temporarily impact policy updates or new initiatives, TRANSPLANT PROCEDURES WILL CONTINUE. Transplant hospitals can perform day-to-day operations independently, although they must still adhere to existing HHS policies. This temporary halt is not expected to significantly disrupt the transplant system, but it is crucial to stay informed of any potential updates or changes that may arise.
WHAT CAN YOU DO NOW?
Educate yourself with the below links.
Stay engaged in our community
Keep in contact with your transplant team
Advocate with us by filling out a volunteer application for us
Learn More About OPTN Modernization
For those interested in learning more about the recent OPTN modernization efforts please visit: https://www.hrsa.gov/optn-modernization/march-2023
OPTN Vice President of Patient and Donor Affairs, Macey Levan, PhD, is answering many questions for what is new in transplant for 2025 in a webinar on January 31st. You can register here: https://wp.nyu.edu/centerforbioethics/event/organ-procurement-and-transplantation-network-modernization-what-to-expect-in-2025/
We highly encourage you to view her last webinar which gives the history of the OPTN until Modernization here: https://youtu.be/4rZHaiOIPCI?si=xjsTTy0LFlHwM9dW
**Know there are currently 3 parent caregivers and a handful of pediatricians currently on the board doing their best to make sure recipient children, as a vulnerable population stay a priority.
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