Washington, D.C. — Today, during a hearing of the Senate Finance Subcommittee on Health, U.S. Senator Elizabeth Warren (D-Mass.) called out United Network of Organ Sharing’s (UNOS) misinformation, the only organization to ever hold the Organ Procurement and Transplantation Network (OPTN) contract, and explained how UNOS is trying to preserve their monopoly. 

 

Senator Warren called out UNOS’s anti-competitive behavior and asked Molly McCarthy, a three time transplant patient and Vice Chair & Region 6 Patient Affairs Committee Representative for the OPTN,  about UNOS’s misinformation. She affirmed that she would not have any concerns with Health Resources and Services Administration breaking up UNOS’s monopoly and awarding multiple OTPN contracts, “We need to have diversity so that we can have the best in-class serving patients.”

 

Senator Warren emphasized the need to pass the Securing the U.S. Organ Procurement and Transplantation Network Act, to stamp out corruption in the current system to improve patient outcomes. 

Transcript: Reforming the U.S. Transplant System
U.S. Senate Finance Subcommittee on Health 
Thursday, July 20, 2023

 

Senator Elizabeth Warren: Thank you, Mr. Chairman. The Organ Procurement and Transplantation Network, or OPTN, was established by the federal government to manage the U.S. organ donation program. And today, OPTN is run by the United Network of Organ Sharing, or UNOS, which is the only entity ever to have been awarded this federal contract.

 

Last year, the Senate Finance Committee released the findings of an investigation into UNOS that revealed that this system is deeply broken. Organs are getting lost in transit. Infected organs are being transplanted into patients. And the individuals responsible for running the system are riddled with conflicts of interest.

 

So, let’s talk about one of these conflicts. Federal law requires OPTN to have a board of directors. Makes sense – most organizations are governed by a board of directors that, when working properly, serve as a check on the organization’s performance and management.

 

Ms. McCarthy, you are a transplant patient yourself and you serve as Vice Chair of the OPTN’s Patient Affairs Committee, so you see up close the governance of the OPTN firsthand. So tell me, Ms. McCarthy, is there any difference in membership between the UNOS board of directors and the OPTN board of directors?

 

Molly McCarthy, Vice Chair & Region 6 Patient Affairs Committee Representative, Organ Procurement and Transplantation Network: Senator, there's not. They're absolutely the same people.

 

Senator Warren: So, they are identical. And right now, that means the same people are in charge of overseeing how well the contractor runs the organ donation system, and those are the same people who are actually running it. 

 

So, Ms. McCarthy, how does this governance structure affect the integrity of the organ transplant system?

 

Ms. McCarthy: I would argue there's no integrity in the system. There's no accountability, there's no transparency. And sadly, the cost of that is that people are dying every day.

 

Senator Warren: So what you're telling me is nobody holds themselves accountable, because this is an identity of interest? Okay. My view on this is that OPTN changes are long overdue, and I support the reforms HRSA, the federal agency overseeing the OPTN. It was announced earlier this year that we’re going to move in this direction. 

 

I also joined Chair Wyden in introducing legislation to give HRSA additional statutory authority to strengthen government oversight. 

 

Among many reforms, the legislation would support HRSA’s proposal to break up the OPTN monopoly contract into multiple smaller contracts which would allow some competition and allow the best vendors in the business to manage different parts of the transplant network operation. That means hiring IT experts to do the IT, it means hiring logistics experts to do logistics, and so on.

Now, UNOS does not want to lose control though, so they’re pushing the government to limit eligibility only to nonprofit vendors that have worked in the past on organ donation – meaning, for instance, that the IT company that is hired to run OPTN’s computer systems would have had to to have worked on an organ transplant network in the past and be a nonprofit.

 

So, Ms. McCarthy, the requirement UNOS wants would seem to make it so that only one organization could apply for the new contract: UNOS. Would you have any concerns if HRSA awarded part of the OPTN contract to an entity that does not fit this narrow description?

 

Ms. McCarthy: Senator, absolutely not, quite the contrary. We need to have diversity so that we can have the best in-class serving patients.

 

Senator Warren: I’m glad to hear this. You know, I think what we’re seeing here is nothing more than UNOS trying to protect its monopoly.

 

The reforms that we proposed are a commonsense step that everyone should be able to agree on. Right now, Congress has an opportunity to root out corruption in this system – but if we don’t act before the current contract expires, we won’t have another shot for years.

 

Patients have waited long enough. Congress should pass the Securing the U.S. Organ Procurement and Transplantation Network Act and do it without delay. Thank you, thank you all for being here and for your work. Thank you, Mr. Chairman.