The Trump administration on Dec. 17, pushed for a review of the national transplant system, “increasing accountability and availability of the organ supply” by monitoring the effectiveness of deceased donor recruitment and providing facilities for living donors.
The new measures are available for public comment from Dec. 17 for 60 days—before they took effect—and would follow on from those ordered by Donald J. Trump to combat kidney disease in July.
The president announced at the time that his goal was to combat the severe organ shortage and “make life better and longer for millions” of Americans, according to The Associated Press.
Now, the ambitious initiative proposes to extend for the rest of the transplants the same points that the president focused on kidney transplants at a time when the country has a waiting list of more than 113,000 transplant patients, of whom about 20 die every day.
“Our broken system of procuring organs and supporting kidney donors’ costs thousands of American lives each year,” said Health and Human Services (HHS) Secretary Alex Azar.
“Many organ procurement organizations do wonderful work, but some aren’t performing nearly as well as they could,” Azar added, concluding, “We’re going to stop looking the other way while lives are lost and hold OPOs (organ procurement organizations) accountable.”
Accountability and availability
Therefore, one of the points would be to implement new controls for the OPOs, in order to improve their performance since, according to reports, some are securing deceased donors at half the rate of others.
It is worth mentioning that so far, the work of OPOs has not been monitored, so there was no way of knowing how many potential donors were lost and why, and therefore no accountability could be enforced.
Under the new regulations, the effectiveness ratio of each OPO would be calculated on the basis of federal death records that reflect the overall count of potential donors in the 58 zones into which the country is divided.
The other point would be to encourage, simultaneously, living donors by offering them “reimbursable expenses for living donors to include lost wages, and child care and eldercare expenses.”
It was reported that organs from living donors accounted for 19% of the 36,529 transplants performed in 2018, or about 7,000.
Along these lines, a 2017 study carried out by the University of Pennsylvania concluded that if the US managed to optimize its national transplant system it could obtain up to 28,000 additional organs.
“Every day, twenty Americans die waiting for an organ and thousands of Americans are languishing on waitlists. That is unacceptable and represents a missed opportunity to save lives and improve patients’ quality of life,” determined Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma.
“Under President Trump’s leadership, CMS is tackling this longstanding issue in the health care system by proposing decisive action to raise performance standards for organ procurement organizations and incentivizing them to facilitate transplant of as many viable organs as they can,” even if they are imperfect, he said.
“An imperfect organ is better than no organ at all. For someone on a waitlist, that may mean the difference between life and death,” Verma said.