Innovation, oversight is needed to make more organs available for critically ill patients.
It wasn’t all that long ago that organ transplants were considered such pioneering medical marvels that the surgeries generated headlines in newspapers like this one. Today, they’re a far more established part of medicine, with patients able to seek care close to home vs. traveling to the University of Minnesota, home of one of the world’s earliest and most respected organ transplant centers.
Technology, surgical advances and better drugs have improved survival rates from those early days and enhanced the quality of life after the procedures. Unfortunately, innovation hasn’t kept pace in a critical, related area: organ procurement. Demand still tragically outstrips supply.
“Each year, some 23,000 Americans receive a lifesaving heart, liver, lung or kidney transplant from a deceased donor,” according to a recent, important report from the Bridgespan Group, a Boston-based nonprofit. Yet, the waiting list for these gifts of life tops 115,000. Between 6,000 and 8,000 people die each year waiting for the call that an organ is available. That’s about 22 a day on average.
The persistence of this tragic gap is frustrating given the relative ease with which people can sign up to become organ donors should the unthinkable happen. Those who get a driver’s license have a chance to make their wishes known. Another alternative: signing up online at organdonor.gov .
But adding to donors’ ranks is only part of the solution, as the Bridgespan report makes clear. The report, issued earlier this year, put an overdue spotlight on the 58 nonprofit organ procurement organizations (OPOs) that the nation relies on to get organs from recently deceased donors to the critically ill patients who need them.
What the report found is that performance varies disturbingly between regional OPOs, with “many persistent underperformers failing to improve over the last decade.” One key problem: an OPO evaluation system that “does not actually reward pursuing every organ, every time.” A University of Pennsylvania analysis cited in the report has a grim conclusion: Up to 28,000 organs available for donation do not make their way to the surgical suite each year because some OPOs are not aggressive enough.
In addition to increasing the number of organs available for transplant, changes could also save billions in taxpayer dollars. Those who are waiting for a transplant require intense and expensive medical care. Many of these patients rely on public medical programs for coverage. In 2014, the cost of dialysis for those waiting for kidney transplant came to $26 billion.
Bipartisan calls for reform have commendably come after the report’s release. In July, President Donald Trump ordered U.S. Health and Human Services Secretary Alex Azar to improve OPO oversight. Elizabeth Warren and Richard Blumenthal, both Democrats, also urged Azar’s agency to make reforms a priority.
The latest push for reform came this month from California Democratic Rep. Katie Porter. The House freshman has become a social media star for her take-no-prisoners questioning of bank executives and others.
Like Warren and Blumenthal, she’s urging federal officials to improve oversight and accountability, and her well-researched letter to them is even more damning than the Bridgespan report. Among its highlights: that the OPO serving Porter’s district improperly spent money on Rose Bowl tickets, hotel rooms and limousines - diverting dollars from those it serves.
Porter’s involvement put a fresh spotlight on the OPO issue, and her media savvy makes her involvement especially welcome. Congressional leadership is needed to enact strong agency-level reforms and, if necessary, follow up with legislation.
“We can’t sit idly by as Americans lose their lives because of financial mismanagement at organ procurement organizations,” Porter said in a statement provided on Tuesday. “The time for accountability is now. Our patients and our community members who have chosen to give the gift of an organ donation deserve no less.”