In a Friday, October 4, Washington Post opinion piece , former White House Office of Science and Technology Policy staffer Jennifer Erickson calls for a reform of the current United States organ procurement system. Erickson cites research that "thousands of organs go unrecovered every year from potential donors across the country." These missed opportunities for organ recovery occur, she argues, due to mismanagement by organ procurement organizations (OPOs), the nonprofit government contractors responsible for organ procurement and placement. Because OPOs self-report their own performance data, the reporting is “functionally useless” with “no system accountability,” said Erickson’s former colleague from the Obama administration U.S. Chief Data Scientist DJ Patil.

However, it’s not just Obama administration veterans scrutinizing OPO performance: the Trump administration, as well as a bipartisan collection of Senators, are leading efforts to overhaul and improve organ procurement efforts—an objective the American Society of Nephrology is also advocating for on Capitol Hill and in interactions with the administration.

“It is indisputable that our deceased-donor organ donation system is not operating at utmost efficiency.  The lack of transparent, verifiable data regarding organ procurement activities is a major limitation to improvement in this critically important effort,” said ASN President Mark E. Rosenberg, MD, FASN, in recent comments to the Centers for Medicare and Medicaid Services. “To best serve the more than 100,000 patients waiting for an organ transplant, we must collectively acknowledge this unfortunate reality and swiftly move to implement better metrics based on consistent data nationwide.”

President Trump's July 2019 Executive Order on Advancing American Kidney Health directed Department of Health and Human Services (HHS) Secretary Azar to "establish more transparent, reliable, and enforceable objective metrics for evaluating an OPO's performance."  As part of Advancing American Kidney Health, the administration has also established the goal of doubling the number of kidneys available for transplant by 2030 and proposed making increasing transplant rates a hallmark of a new mandatory payment model .   Dr. Rosenberg continued “ASN believes that reforming the current system of OPO performance oversight is necessary to enable the goals of Advancing American Kidney Health as well as to approach the proposed target transplant rate described in the proposed model.”

Meanwhile on Capitol Hill, Senator Todd Young (R-IN) and Senator Michael Bennet (D-CO) have introduced legislation calling on HHS to develop metrics that are “objective, verifiable, and not subject to self-interpretation by OPOs.”  Having worked closely with Sen. Young to shape the legislation, ASN is advocating for its advancement in the Senate.

“Recovery rates are not an esoteric data point; when OPOs fail to do their job, patients die,” writes Erickson. “Thousands more Americans could have lifesaving transplants each year if we fix our organ procurement system.”