RICHMOND, Va. (WRIC) — A Richmond-based nonprofit will now no longer have a monopoly on organ transplants in the United States after an announcement from the federal government on Wednesday that marked the intention for better technology, more transparency and more competition in the organ industry.

Last year, the Richmond-based United Network for Organ Sharing (UNOS) came under fire after a two-and-a-half year long investigation from the U.S. Senate Finance Committee on the organization’s alleged mismanagement.

Some of the mismanagement stemmed from the monopoly that UNOS has held over the organ transplant industry for just under 40 years.

The Organ Procurement and Transplantation Network (OPTN), the first computerized system to match patients with organs, was started in 1984. At the time, UNOS was the only organization that bid on the right manage the system for the whole country. UNOS was awarded its first contract in 1986.

In 2022, that contract was worth about $64 million a year, the majority of which came from hospitals and Organ Procurement Organizations (OPOs).

During a committee hearing in August 2022, both lawmakers and doctors spoke to issues within the organ matching space, from patients becoming sick following organ transplants to a doctor who had to throw away a kidney because it arrived frozen.

According to CNN, UNOS has also dealt with a history of long waitlists for transplants, which in many cases have been deadly. CNN reported that over 100,000 people are waiting for an organ transplant every year in the United State and around 6,000 die each year before they can receive the organ they need.

There were also more technical problems at hand. During that committee hearing, Diane Brockmeier, President and CEO of Mid-America Transplant in Missouri, stated that at the time, OPOs were required to use UNOS’ technology, DonorNet, which depended on manual entries and Brockmeier said was outdated, slow and difficult to use.

“Manual entry subjects it to error, and OPO and transplant center staff are not empowered with the right information when time is critical,” Brockmeier said last summer.

On Wednesday, March 22, the Health Resources and Services Administration (HRSA) moved to resolve some of the issues plaguing the organ transplant industry. The organization announced an initiative that will focus on the accountability and transparency in the OPTN.

The main focus of this initiative is to offer multiple entities contracts to main the OPTN, not just UNOS. The initiative specifically points to issuing multiple contracts for managing OPTN, better allocating resources for the contracts and increasing the pool of eligible contract holders.

According to HRSA, the goal of this change is to foster competition and ensure that the OPTN Board of Directors remains independent.

The initiative also includes a new data dashboard that includes information on organ donors, organ procurement, transplant waitlists and transplant recipients, as well as using money from the President’s Budget for Fiscal Year 2024, which would more than double HRSA’s budget for organ-related work to a total of $67 million.

“Every day, patients and families across the United States rely on the Organ Procurement and Transplantation Network to save the lives of their loved ones who experience organ failure,” Carole Johnson, HRSA Administrator, said. “At HRSA, our stewardship and oversight of this vital work is a top priority. That is why we are taking action to both bring greater transparency to the system and to reform and modernize the OPTN. The individuals and families that depend on this life-saving work deserve no less.”

8News received the following comment from UNOS in light of HRSA’s recent announcement:

UNOS supports HRSA’s plan to introduce additional reforms into the nation’s organ donation and transplantation system. We also stand united with HRSA in our shared goal to get as many donor organs as possible to the patients in need while increasing accountability, transparency and oversight. We welcome a competitive and open bidding process for the next OPTN contract to advance our efforts to save as many lives as possible, as equitably as possible. We believe we have the experience and expertise required to best serve the nation’s patients and to help implement HRSA’s proposed initiatives. Numerous components of HRSA’s plan also align with our new action agenda, which is a list of specific proposals we outlined earlier this year aimed at driving improvement across the system. We are committed to working with HRSA, HHS, Congress and others who care about this system so deeply to assist in carrying out these reforms and to do our part to improve how we serve America’s organ donors, transplant patients and their families. 

Anne Paschke, Media Relations Specialist, UNOS