The Boston Globe

Congress OK’s organ transplant overhaul

- By Lenny Bernstein

WASHINGTON — Congress approved a thorough revamp of the troubled US organ transplant system Thursday, providing health officials with the authority to break monopoly control of the way kidneys, livers, lungs, and other organs are delivered to sick patients.

For 37 years, one nonprofit organizati­on, the United Network for Organ Sharing, has held the federal contract to run the system, relying on a 1986 law that blocked almost all competitio­n. With a unanimous vote Thursday night, the Senate rewrote the law to let the federal Health Resources and Services Administra­tion break that strangleho­ld and solicit bids from other for-profit and nonprofit groups.

The House approved the measure Tuesday. President Biden is expected to sign it.

The expected law holds the promise of significan­t change to the hidebound transplant system, which has been beset for years by long waits for organs, patient deaths, lack of accountabi­lity, poor oversight, and widespread technologi­cal problems.

After new contracts are awarded, Richmond-based UNOS may lose its power to set policy, operate the system’s complex technology, and hold transplant hospitals and organ-collection agencies to account — though UNOS has vowed to try to remain part of the system.

“Today is a monumental day in the effort to improve the organ donation and transplant­ation system for Americans and their families who are counting on transplant­s to save their lives,” said Senator Ron Wyden, Democrat of Oregon, chairman of the Senate Finance Committee, which has been investigat­ing the transplant system for three years.

Exactly how HRSA plans to redesign organ transplant­ation is still being worked out. The agency announced its intention to overhaul the system in March and went to Congress for the authority it needed. HRSA administra­tor Carole Johnson released a statement after the vote saying, “We commend bipartisan leaders in the House and Senate for passing legislatio­n to give HRSA stronger tools to execute this vision.”

Nearly 104,000 people are on the waiting list for organs in the United States, and 22 die each day when compatible kidneys, livers, lungs, and hearts cannot be found in time. A record 42,887 transplant­s were performed in 2022, but research and government reports show many thousands more could be done if the system functioned smoothly.

UNOS did not oppose the legislatio­n. “UNOS is committed to modernizin­g and reforming the nation’s organ donation and transplant system and working with Congress to achieve measurable results for patients,” the organizati­on said in a statement.

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