The American Society of Nephrology (ASN) has issued a press release welcoming the significant changes to the US Organ Procurement and Transplantation Network (OPTN)—a sweeping “OPTN Modernisation Initiative”—announced today by US Health Resources and Services Administration (HRSA) administrator Carole Johnson.
“ASN believes that patients’ access to kidney transplant care is of life-or-death importance, and strongly supports HRSA’s efforts to expedite reforms that will maximise access to transplant care,” said ASN president Michelle A Josephson (University of Chicago, Chiago, USA). “The policy changes announced today are a positive step in the right direction.”
The proposed changes respond directly to ASN’s advocacy for HRSA to improve care for kidney transplant patients and candidates, including the more than 75,000 Americans on the kidney waitlist, by increasing OPTN accountability and transparency as well as modernising its underlying technology and policy infrastructure.
ASN has encouraged separating the OPTN contract into distinct pieces that can be bid on by multiple entities, aligning the contract with federal contracting protocols, increasing competition, and driving innovation—changes towards which today’s announcement makes significant progress.
“ASN has called for increased data-sharing regarding transplant centre and organ procurement organisation practices and outcomes because it is crucial to empower patient decision-making and drive practice and policy changes to ensure greater, more equitable access to kidney transplantation,” said Josephson. “Today’s announcement brings us much closer to the transparency patients, their care teams, the research community, and every American deserve from our kidney health ecosystem,” said ASN Quality Committee chair Scott Bieber (Kootenai Health, Coeur D’Alene, USA).
“Ensuring OPTN’s technology systems are fully modernised and leveraging their capabilities is a foundational step to improving the transparency and efficiency of the kidney health ecosystem and is a prerequisite to achieving ASN’s goal of maximizing access to kidney transplantation. I applaud HRSA’s public commitment to building that capacity and ensuring future systems better serve the needs of patients and their families,” Josephson added.
Having called for the OPTN board of directors to be a separate entity from the boards of any OPTN contractors, ASN states that it applauds HRSA’s commitment to ensuring the OPTN board of directors is high-functioning and has greater independence in the future and awaits further detail from HRSA.
ASN has also commended the recognition that greater resources are needed for OPTN to improve patients’ access to transplantation as the optimal therapy for kidney failure and looks forward to collaborating with Congress and HRSA to enact that funding and fully carry out these crucial reforms, as well as other changes. For example, ASN has called for additional reforms to the transplant system that must be specified beyond today’s announcement, such as the need to collect pre-waitlisting data for transplant candidates.
More clarity and additional statutory changes, including those highlighted by bipartisan congressional leaders, are necessary to meet and complement the commitments HRSA announced today, the ASN press release argues. “ASN is committed to working iteratively with HRSA and Congress to ensure all aims announced today will be optimally implemented,” said ASN Policy and Advocacy Committee chair Roslyn B Mannon (University of Nebraska Medical Center, Omaha, USA). “ASN acknowledges that many simultaneous changes to the current kidney health ecosystem must occur urgently to achieve the goal of maximising access to kidney transplantation and ensuring that access is equitable to all patients regardless of geography, socioeconomic status, race/ethnicity, and gender, and ASN’s members, leaders, and staff look forward to working with Congress and the Department of Health and Human Services to do so moving forward.”
“ASN has a long history of calling for a coordinated, kidney health ecosystem-wide approach that works in synergistic coordination and allows all stakeholders to work towards maximising patients’ access to transplant,” said Josephson. “In 2016, I was privileged to represent ASN at the White House Organ Summit, and in 2019, to witness many pivotal changes signed into policy through the Advancing American Kidney Health Executive Order. Throughout this time, Congressional leaders have carried this momentum forward on a bipartisan basis. I look forward to continuing to work with federal policymakers, patients, and my fellow health care professionals to transform transplant care.”