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Reform organ donation to save lives


August 07, 2019
In Indiana, more than 1,300 Hoosiers are currently in need of an organ transplant. Nationally, more than 113,000 Americans are on the organ wait list.

These aren't just statistics, these are lives.

This issue is personal for me. My friend Dave (Gunny) McFarland from Jeffersonville died because his heart transplant never came. We served together in the Marines, and I've gotten to know his wife, Jennifer, over the years. She has made it her mission to raise awareness about the transplant process, and to help prevent others from facing a similar fate.

Because the organ transplant system is so complex, most people don't know how it works, or if patients are being protected.

Organ procurement organizations, known as OPOs, are the government-monopoly contractors responsible for getting organs from the donors to the patients who need them. Their performance is measured by data that, by their own admission, is self-reported, unaudited and fraught with errors.

OPOs are the main link between donor hospitals and organ recipients, and their performance can be a limiting factor for all stakeholders in the organ donation system.

After a person has passed away, OPOs are supposed to arrive at the hospital to provide surviving family with the information they need to make a decision about donating their loved one's organs.

OPOs don't recover organs in all cases, and families have every right to decline donation. But new research indicates that performance across OPOs varies widely, and too often the OPOs don't show up at all.

At least 15 OPOs recover less than a third of potential organs, and some recover less than a quarter.

If all OPOs recovered at least 50 percent of donations, we could save another 6,000 lives each year. If OPOs recovered 100 percent of donations, an additional 25,000 lives would be saved every year.

Every time an OPO fails to do its job, patients on the organ waiting list die. And yet, in the roughly 30 years this industry has existed, no OPO has lost its governmental contract.

After carefully studying this issue, I recently introduced legislation to bring greater transparency, oversight and accountability to these organizations that so many lives are dependent on.

My legislation would require that the nation's 58 OPOs be held to metrics that are objective, verifiable and not subject to self-interpretation so that there can be meaningful transparency, evaluation and accountability. The president underscored the urgency of this issue with a recent executive order calling for the same thing.

The Centers for Medicare and Medicaid Services recently recertified New York City's OPO, known as LiveOnNY, despite persistent underperformance for nearly a decade, and this problem exists throughout the country.

Until we fix the deeply broken system, people will continue to face lengthy, demoralizing wait lists and death.

My legislation aims to help save lives, which I wish we could have done for my friend. And while the lifesaving potential of this reform is the primary goal, the fiscal implications are also important.

For example, patients waiting for kidney transplants are often placed on dialysis as a life-sustaining solution, which is a difficult and costly treatment. Because kidney failure qualifies patients for Medicare, dialysis costs taxpayers more than $35 billion annually.

Transplants on the other hand are far more cost-effective.

Research by Nobel Prize-winning economist Al Roth shows that each kidney transplant can save taxpayers at least $250,000 per patient in avoided dialysis costs. So, improving OPO performance could also save taxpayers up to $12 billion in just five years.

I won't stop working on this issue until we increase the availability of organs for patients in need and eliminate the inefficiencies occurring in our organ donation system.

It's time for OPOs to be held accountable — thousands of lives are at stake.

Todd Young, R-Indiana, is in his first term in the U.S. Senate. He previously served three terms as the congressman for Indiana's Ninth District. This editorial first appeared in The Hill.

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