In March 2023, the Health Resources and Services Administration (HRSA) announced it would be making changes to the U.S. organ transplant system. Many groups, including the National Kidney Foundation (NKF), are hopeful that these changes will be patient-centered and improve equity in the kidney transplant process. Learn more about the changes and why they came about.* 

Who currently manages organ transplants?

In the mid-1980s, the National Organ Transplant Act (NOTA) established an Organ Procurement and Transplantation Network (OPTN) to run the national registry that matches organ donors with recipients. NOTA also created a contract for a private, non-profit organization to manage OPTN and the national registry. The United Network for Organ Sharing (UNOS) was selected and has won the contract for bid renewal every year. 

Why is HRSA making changes?

While they are two separate organizations, OPTN and UNOS share the same board of directors and committees. This makes it difficult to tell them apart, and has led to a monopoly on the transplant system for decades. Moreover, concerns have been broached concerning their management of transplants. These concerns include:

• Racial and ethnic disparities
• An increase in organ shortages, with recovered organs going to waste 
• Outdated IT systems and architecture 

To help address these issues, HRSA plans to end the contract and allow others to bid on specific parts of the agreement. 

What could this mean for patients?

The NKF and many others are optimistic that these changes will lead to more patients receiving the care they need and deserve. HRSA plans to meet the needs of patients and families by:

• Making transplant access equitable
• Prioritizing collaborative decision-making through data sharing
• Improving safety and health outcomes

Do you need support now on the transplant process? Learn more about every aspect of the transplant process and how NKF can help you on your journey. 

*HRSA’s Plan to Modernize the Transplant System. (2023, April 10). National Kidney Foundation. https://www.kidney.org/newsletter/advocacy/hrsa-s-plan-to-modernize-transplant-system