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Q: Why are you working to improve the nation’s organ procurement system?

A: Ask anyone who has had a loved one on the organ transplant list or waiting for approval to get on it. The uncertainty and anguish to find a match can turn into an emotional roller coaster. According to federal figures, 17 people die each day in America waiting for an organ transplant. Currently, more than 106,000 individuals are on the national transplant wait list. So, obviously the wait is a matter of life and death for tens of thousands of family members, friends, co-workers or neighbors across the country. The federal law regulating the nation’s organ transplant ecosystem was enacted nearly four decades ago. It created the Organ Procurement and Transplantation Network (OPTN) to manage regional Organ Procurement Organizations (OPOs). Since 1986, the United Network for Organ Sharing (UNOS) contracts with the federal government to facilitate procurement among the 57 OPOs. Each OPO operates as a regional monopoly, providing services to patients in a geographic area. A couple years ago, I joined Sen. Ron Wyden to dig into troubling details about underperformance and improper use of Medicare funds. Recent audits flagged tens of thousands of organs going unrecovered or not transplanted. Gaps in oversight, conflicts of interest and inadequate patient safety undermine the public trust. These alarming findings effectively mean lives are hanging in the balance due to mismanagement by OPOs. I’ll continue my oversight work to improve the OPTN system, restore the public trust and move the needle on underperforming OPOs around the country. It’s a matter of fairness to patients, families and taxpayers.


Q: What issue recently came to your attention about patients getting denied access to the wait list?

A: Like every facet of society, the pandemic also added uncertainty to the organ transplant system. When the virus hit our shores, patient advocates harbored concerns the pandemic would lead to unnecessary loss of life due to a decline in organ donations and transplants. Last year, more than 40,000 transplants were performed in the U.S. New reports from around the country have shown patients are being removed from organ transplant lists for not receiving the COVID-19 vaccine. I’ve advocated for updates to federal rules to help incentivize more procurements, recoveries and matches for all Americans, regardless of race, ethnicity or geography. The same goes for Americans who choose not to receive the COVID-19 vaccine. There are medical reasons why patients seeking a transplant may delay a vaccine. Lifesaving organ transplants should be made available to all Americans. I joined Sen. Ted Cruz to co-sponsor legislation that would prohibit OPOs from denying an individual from donating or receiving an organ based on vaccine status or using the number of COVID-19 cases in a region from being used as an eligibility factor.

During the Trump administration I supported new federal rules to standardize the metrics measuring potential donors. Transparency brings accountability. Letting the sun shine in on OPOs will help protect taxpayer dollars and save more lives. Nailing down performance metrics, such as waitlist survival, transplant rates and increasing potential donor pools, are important benchmarks to measure success and improve operations. Although OPOs have seen an increase in the donor pool, the uptick in organ donations tragically is largely attributable to the spike in opioid deaths, as well as improved technologies to increase the viability of an organ. The U.S. spends about 20 percent of Medicare funding on Americans with kidney disease. Most patients (84 percent) who are on the wait list need a kidney. Improving the efficiency and accountability of the organ procurement system would save lives, improve quality of life and save taxpayer dollars if fewer Americans required expensive and time-consuming dialysis treatments. I’ll keep working to flush out underperforming OPOs so our system is able to move more Americans from the wait list to a life of hope, healing and recovery. That includes whether Americans choose to get vaccinated or not.

April celebrates Donate Life Month to raise awareness about the gift of life through organ donation. Across the United States, 169 million people have registered as donors. A single organ donor can save up to eight lives. To register as a donor or learn more about organ donation, visit the IowaDonorNetwork.org.

Author: Charles Grassley

Chuck Grassley of New Hartford has represented Iowa in the United States Senate since 1980.

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