HHS Expands Oversight of Organ Transplant System with New Surveillance Tool

WASHINGTON — The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), launched a public dashboard that surveils when organ offers and transplants occur outside the standard list of matched patients. The tool tracks trends to help HHS crack down on noncompliance and give patients, families, and clinicians clear information about whether the system is operating fairly.

HRSA’s surveillance tool delivers on HHS Secretary Robert F. Kennedy, Jr.’s major reform initiative to strengthen the integrity of the transplant system and restore public confidence following HRSA investigations that revealed disturbing practices related to patients being skipped for transplant and patient safety concerns in organ procurement.

In the United States, every organ offer follows a computerized “match run” that ranks patients based on medical urgency, distance, and other rules meant to ensure fairness. When that order is not followed, it results in an “allocation out of sequence” (AOOS) event. These occur when an organ is offered, accepted, or transplanted in a way that differs from the expected match order.

“Every patient and family waiting for a transplant deserves a fair, transparent, and accountable process,” said HRSA Administrator Tom Engels. “This dashboard is a concrete step toward that promise. By shining a light on potential out-of-sequence events, we are inviting clinicians, patients, and researchers to help us spot patterns, correct problems, and continuously improve the system. Transparency is how we earn trust, and how we save more lives.”

The AOOS dashboard provides:

• Clear visibility into potential out of sequence allocation patterns by organization and timeframe
• Policy context and technical notes to help users understand why an organ may have been offered out of order
• Oversight safeguards to give patients and the public confidence that allocation rules are being followed

The AOOS dashboard is part of HRSA’s broader program to fix the Organ Procurement and Transplantation Network (OPTN). Along with the new surveillance tool, HRSA has created a misconduct reporting process for organ donation, procurement, or transplantation, and proposed requirements on organ procurement organizations to detail their interactions with hospitals and patients referred for donation.

About the Organ Procurement and Transplantation Network

The OPTN is the national system that manages organ transplants in the United States. Created under the National Organ Transplant Act, the OPTN sets policies, maintains the national waiting list, and matches donors with recipients to ensure fair allocation.

HRSA oversees the OPTN, with responsibilities that include preventing fraud and abuse, addressing errors affecting patients, monitoring safety and public health, and ensuring the system works as intended.