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28,000 organs go unrecovered every year,

leading to loss of life and increased Medicare costs



could be saved for taxpayers in just 10 years through reform

are currently on the waiting list for a lifesaving organ 

die every day in need of a transplant

The Problem

The organ donation system is grossly inefficient, failing to recover and transplant as many as 28,000 lifesaving organs every year. 


The problem is a system of unaccountable, government monopoly contractors with a history of failure to recover lifesaving organs, fatal lapses in patient safety, obstructionism, and fraud, waste and abuse. These include the national contractor that runs the organ procurement transplantation network (UNOS) and many local contractors called organ procurement organizations (OPOs).


As the New York Times editorial board wrote: “an astounding lack of accountability and oversight in the nation’s creaking, monopolistic organ transplant system is allowing hundreds of thousands of potential organ donations to fall through the cracks."


UNOS and OPO failures also disproportionately harm patients of color. To learn more, read the recent Senate Finance Committee report on failures at UNOS, and a data visualization of OPO performance around the country.


Congress: investigate the government monopoly contractors in charge of organ donation

HHS: Hold OPOs accountable by swiftly enforcing newly-finalized metrics

HHS: should reform its governance and oversight structures for OPOs, including through the creation of a dedicated Office of Organ Policy

The Administration is moving on the issue but it’s critical not to lose momentum during COVID- 19, especially since COVID-19 puts patients at additional risk via dialysis centers and added risk of organ failure

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July 2019: Executive Order on Advancing American Kidney Health, highlighting the need for OPO reform

December 2019: HHS proposed new OPO regulations, finding more than half of all OPOs to be out of compliance. Secretary Azar’s official remarks: “We’re going to stop looking the other way while lives are lost and hold OPOs accountable.”


November 2020: HHS finalized new OPO metrics, projected to save 7,300 additional lives every year once implemented.

Areas in the red failing outcome measures proposed by HHS in 2019 

“Recent reports suggest that OPOs, which are tasked with acquiring and distributing organs for donation, are systemically underperforming, resulting in long wait lists and thousands of deaths each year.”

Senators Elizabeth Warren and Richard Blumenthal

—  Name, Title


Oversight letters:

Statements of Support:





  • House Appropriations Committee: “The Committee supports... efforts to establish objective outcome measures for Organ Procurement Organizations (OPO) as well as efforts to decertify underperforming OPOs at the conclusion of the current contract cycles.”

  • Congressional Research Service: “Under the proposed rule, based on most recent performance data, many OPOs would not meet the measures required to be recertified.”

Stakeholder Reports: 

“We’re going to stop looking the other way while lives are lost and hold OPOs accountable.”  

Secretary Alex Azar

—  Name, Title


Organize Connect

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