US gov’t cracks down on fatal flaws in organ transplant system

First came reports of patients showing signs of life during organ retrieval. Then came a New York Times investigation and congressional scrutiny.

Now, the federal government is cracking down on the US organ donation system in an effort to protect patients on both sides—donor and recipient—from systematic safety lapses.

What’s going on?

Recent probes have uncovered two main problems with organ procurement organizations, the nonprofit groups in each state that arrange transplants.

1) Improper harvesting procedures. Several investigations found that organ procurement groups in several states pressed forward with harvesting—even when patients showed signs of growing alertness.

• In one case, signs of recovery in a New Mexico woman were dismissed until she awoke just before a planned organ removal.
• Another case involved doctors who only realized an Alabama woman was alive after they began cutting into her😳.
• A federal review of Kentucky’s organ donation system also found 73 instances of doctors ignoring signs of increasing consciousness in potential donors.

2) Bypassing transplant waitlists. In February, the NYT reported that procurement orgs were increasingly violating regulations by ignoring waiting lists and sending organs to patients who hadn’t been waiting as long as others, and weren’t as sick. Patients were skipped for ~20% of all US organ transplants last year, or 6x as often as just a few years earlier.

• The orgs said they bypassed patients so that organs at risk of becoming unusable didn’t go to waste.
• But the NYT’s report found they often did it to save time, or to send organs to hospitals where they had relationships.

But...The Association of Organ Procurement Organizations, a national trade group, has also emphasized that safety errors in organ donation remain rare.

Some changes are on the way

Federal officials are rewriting the rules around organ donation to mandate more rigorous reporting, give frontline staff authority to halt retrievals, and more harshly penalize groups who violate the rules.

Big picture: At least 20,000 Americans have removed themselves from state organ donor registries since late July, when the NY Times first reported of premature attempts to remove organs across the US. There are currently 100,000+ patients on US organ donor waiting lists.