Enhancing Accountability and Performance of the Organ Transplant System to Improve Outcomes and Save Lives

Organ transplants can only continue to be lifesaving operations if the system overseeing them is safe, fair, and effective. The Organ Procurement and Transplantation Network (OPTN) creates and monitors the policies that govern how organs are allocated and the operations of all membership organizations. The thousands of Americans who receive transplants each year, who are waiting for an available organ, who are registered or prospective donors, and their loved ones all are relying on this complex system to operate well.

Concerns around operational and logistical challenges, as well as governance, transparency, and public trust, prompted the Health Resources and Services Administration (HRSA) to launch the OPTN Modernization Initiative in 2023.

AIR works in partnership with HRSA and the OPTN Board of Directors to improve efficiency, fairness, and patient outcomes across the system. Through this effort, AIR: 

• Supports the OPTN Board of Directors. AIR facilitated the transition to a new OPTN Board of Directors, holding a national election for an entirely new 35-member board. AIR also updates and refines governance structures; establishes conflict-of-interest safeguards; and ensures transparent policy decisions and prioritization.  
   
• Helps ensure patient safety and compliance. Board-directed workgroups address emergent patient safety concerns, such as allocating organs out of the match sequence (i.e., allocations that do not follow the typical match list order) and normothermic regional perfusion (i.e., a method used on a deceased donor to help preserve organs). 
  
  AIR supports these workgroups by summarizing key actions and drafting policy language. AIR also supports the board in addressing member compliance issues and accountability. For example, AIR has supported board actions in two instances that culminated in recommendations to the HHS Secretary to permanently close two organ procurement organizations with ongoing patient safety and quality concerns. 
   
• Improves communication and public engagement. To rebuild public trust in organ transplantation, AIR develops community-focused messaging, supports public engagement, and increases transparency around policies and decisions.  

AIR’s partnership with HRSA and the OPTN Board of Directors has resulted in: 

• Updated governance structures, including the OPTN Bylaws and the OPTN Management and Membership Policies, more efficient decision-making, the development of policy prioritization tools, and a redefined nomination and recruitment process for the OPTN’s volunteers; and 
   
• Expanded communications and public engagement efforts, including monthly community newsletters to make policies and the OPTN’s activities more accessible to members of the transplantation community, including patients and their families, and strengthen their role in decision-making.  

While this work is ongoing, these improvements have positioned the OPTN to increase efficiency, bolster quality, rebuild trust in the system, and help more patients receive lifesaving transplants.