Report: The US organ transplant network is failing desperate patients

A government report details aging software, programming mistakes and more.

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BERLIN, GERMANY - SEPTEMBER 28:  In a media event provided by the German Foundation for Organ Transplants (Deutsche Stiftung Organtransplantation) a driver places an empty styrofoam box used for transporting human organs into his van at the Vivantes Neukoelln clinic on September 28, 2012 in Berlin, Germany. German politicians and health officials are debating the country's current system for matching doners with recipients following a scandal earlier in the year in which some patients were given preferential treatment at several hospitals. Vivantes clinics were not involved in the scandal.  (Photo by Sean Gallup/Getty Images)
Sean Gallup via Getty Images

The US network that matches donated kidneys, livers and hearts with desperate patients has serious issues and "needs to be vastly restructured," according to a government review seen by The Washington Post. It reportedly relies on out-of-date technology, has crashed for hours at a time and has never been audited by federal for security or other flaws by federal officials.  

The current system has been administered by the United Network for Organ Sharing (UNOS) for 36 years. That non-profit is overseen by the Health Resources and Services Administration. Around 106,000 people are on a waiting list for organs, with most seeking kidneys. Over 41,000 organs were transplanted last year, setting a record, but 22 people die each day waiting, according to the article. 

In its review completed 18 months ago, the White House's US Digital Service recommended that the government "break up the current monopoly" held by UNOS. "In order to properly and equitably support the critical needs of these patients, the ecosystem needs to be vastly restructured." A big sticking point is that the government has never been allowed to inspect the computer code behind the system, because UNOS hasn't allowed it. "The code is extremely large," said UNOS chief executive Brian Shepherd. "They can come in and ask for specific pieces."

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The Washington Post obtained the review in draft form as it has yet to be finalized. Leaders of the Senate Finance Committee who saw the report reportedly warned DHS officials that they had "no confidence" in the security of the network, asking the White House to step in to protect it from attacks. "We request you take immediate steps to secure the national Organ Procurement and Transplantation Network system from cyber-attacks," wrote committee chair Sen. Ron Wyden and Sen. Charles E. Grassley. 

The other main issue is the requirement for manual input that can lead to mistakes or create timing issues for organ matches. "When nearly 100 percent of hospitals use electronic records, the notion that we rely on human beings to enter data into databases is crazy. It should be 85 to 95 percent automatic," a former chair of the UNOS liver transplant policy committee told The Post.

The transplant results are the most disconcerting part of the report. In the US in 2020, 21.3 percent of donated kidneys weren't transplanted, according to a report. That compares to 9.1 percent in France, 10 to 12 percent in the UK and eight percent in the Eurotransplant consortium of eight EU countries including Germany. "You would be hard pressed to think you couldn’t at least get 5 percent better [in the US], which would be thousands of transplants," a former HHS official told The Post. For more, check out the article here

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