Abstract
Abstract. Over 107,000 Americans are currently awaiting a lifesaving organ transplant. The vast shortage of organs for transplant in the United States is commonly known, but few are aware that the capacity exists for an additional 28,000 organs to be procured each year. These viable organs are not procured because of the limitations of the market and governance structure of the organizations primarily responsible for organ procurement across the United States, Organ Procurement Organizations (OPOs). In this paper, the author provides an overview of the current organ procurement system and its flaws, debates the newly revised organ procurement regulations to come into effect in 2022, and offers a sweeping, market-based reform proposal for the organ procurement system.
Keywords. Organ procurement, Organ procurement organizations (OPOs).
JEL. I10, I11, I18.References
Diamond, D. (2019). Coming today: New organ donation rules. Politico, 17 Dec. 2019. [Retrieved from].
Doby, B.L., Boyarsky, B.J., Gentry, S., & Segev, D.L. (2019). Improving OPO performance through national data availability. American Journal of Transplantation, 19(10), 2675–2677. doi. 10.1111/ajt.15508
Doby, B.L., Ross-Driscoll, K., Shuck, M., Wadsworth, M., Durand, C.M., & Lynch, R.J. (2021). Public discourse and policy change: Absence of harm from increased oversight and transparency in OPO performance. American Journal of Transplantation, 21(8), 2646-2652. doi. 10.1111/ajt.16527
Doby, B.L., Hanner, K., Johnson,S., Purnell, T.S., Shah, M.B., & Lynch, R.J. (2021). Results of a data‐driven performance improvement initiative in organ donation. American Journal of Transplantation, 21(7), 2555-2562. doi. 10.1111/ajt.16442
Goldberg, D., et al. (2017). Changing metrics of organ procurement organization performance in order to increase organ donation rates in the United States. American Journal of Transplantation, 17(2), 3183–3192. doi. 10.1111/ajt.14391
Hanke, S. (2018). Let's fund the border wall and save up to 5,000 lives a year, too. Forbes, Forbes Magazine, 29 Dec. [Retrieved from].
Hanke, S. (2019). President Trump delivers lifesaving deregulation. Forbes Magazine, 11 July. [Retrieved from].
Held, R.J., Bragg-Gresham, J.L., Peters, T., Chertow, G.M., McCormick, F., & Roberts, J.P. (2019). The cost of procuring deceased donor kidneys: Evidence from OPO cost reports 2013‐2017. American Journal of Transplantation, 20(4), 1087-1094. doi. 10.1111/ajt.15669
Held, P.J., & Bragg-Gresham, J., Thomas G.P., McCormick, F., Chertow, G., Vaughan, W., & Roberts, J. (2021). Cost structures of US organ procurement organizations, Transplantation: doi. 10.1097/TP.0000000000003667
Kessler, J., & Roth, A.E. (2014). Getting more organs for transplantation. American Economic Review, 104(5), 425-430. doi. 10.1257/aer.104.5.425
Rosenberg, P. (2020). Transforming organ donation in America. Bridgespan.org, The Bridgespan Group, Nov. 2020. [Retrieved from].
Traino, H.M., Alolod, G.P., Shafer, T., & Siminoff, L.A. (2012). Interim results of a national test of the rapid assessment of hospital procurement barriers in donation (RAPiD). American Journal of Transplantation, 12(11), 3094-3103. doi. 10.1111%2Fj.1600-6143.2012.04220.x
United States, Congress, (1984). National Organ Transplant Act. 1984. 42 USC 273.
Other
“Acceptable Ischemic Times.” Nebraska Organ Recovery - Organ Donation in Nebraska, [Retrieved from].
“Advancing American Kidney Health.” Federal Register, 15 July 2019, [Retrieved from].
Center, LifeGift Organ Donation. “US Organ Donation Breakthrough Collaborative Increases... : Critical Care Nursing Quarterly.” LWW, 2008, [Retrieved from].
“The Deceased Donation Process.” Organ Donor, 22 Aug. 2018, [Retrieved from].
“Fact Sheet Organ Procurement Organization (OPO) Conditions for Coverage Proposed Rule: Revisions to Outcome Measures for OPOs.” CMS, 17 Dec. 2019, [Retrieved from].
“Letters to Organ Procurement Organizations (OPOs).” House Committee on Oversight and Reform, 23 Dec. 2020, [Retrieved from].
“Medicare and Medicaid Programs; Organ Procurement Organizations Conditions for Coverage: Revisions to the Outcome Measure Requirements for Organ Procurement Organization.” Federal Register, 23 Dec. 2019, [Retrieved from].
“Medicare and Medicaid Programs; Organ Procurement Organizations Conditions for Coverage: Revisions to the Outcome Measure Requirements for Organ Procurement Organizations.” Federal Register, 2 Dec. 2020, [Retrieved from].
“New to State Operations Manual (SOM) Appendix Y- Organ Procurement Organization (OPO) Interpretive Guidance.” Center for Medicare and Medicaid Services , 23 May 2014, [Retrieved from].
“OPO Final Rule.” ORGANIZE, [Retrieved from].
“Organ Donation Statistics.” Organ Donor, 28 Sept. 2020, [Retrieved from].
“Organ Procurement and Transplantation Network: Data.” OPTN, 16 Feb. 2021, [Retrieved from].
“Organ Procurement Organization (OPO) Reports.” OPO-Specific Reports, [Retrieved from].
“Reforming Organ Donation in America.” Bridgespan.org, The Bridgespan Group, Jan. 2019, [Retrieved from].
“Timeline of Historical Events and Significant Milestones.” Organ Donor, 4 Dec. 2018, [Retrieved from].
