We are better together. That is the theme of the 50,000 Organ Transplants Campaign, and it is contained in the new Association of Organ Procurement Organizations’ (AOPO) comment letter –  collaboration and a focus on overall improvement of the donation and transplantation system will help save more lives.

AOPO Comment Letter
The Biden Administration has allowed for additional comment on the Centers for Medicare and Medicaid Services’ rule impacting organ procurement organizations (OPOs). AOPO supports revisions to the OPO conditions for coverage. But we believe collaboration will lead to the most meaningful progress and that means looking at the process with all of its stakeholders, not just OPOs. AOPO has four recommendations outlined in its new letter to CMS.

Recommendation 1: AOPO agrees it is important to hold all parties to high standards to ensure the system is working efficiently and effectively. Unfortunately, the “aggressive” competition-style tiering system for OPOs finalized in this rule threatens to upend the organ procurement system, which will ultimately harm patients. AOPO recommends CMS instead work collaboratively with stakeholders to recalibrate its approach, reserving decertification for the lowest performers and incentivizing other OPOs to consistently improve while moving toward objective, evidence-based performance thresholds.

Recommendation 2: Work toward improving the accuracy of both organ donation and transplantation rate outcome measures. This would be accomplished by refining the donor pool to exclude deaths with no donation potential while actively working toward identifying alternative, more reliable data sources in the future, such as hospital inpatient deaths previously on a ventilator.

Recommendation 3: CMS should replace the organ transplantation rate outcome measure with the more accurate, dynamic, and non-duplicative Observed to Expected Yield (O/E) measure. The O/E measure is more accurate because it adjusts to factors outside the control of the OPO that impact the success or failure of placing an available organ for transplant.

Recommendation 4: CMS should work with AOPO, the Organ Procurement and Transplantation Network (OPTN), the Scientific Registry of Transplant Recipients (SRTR), and other members of the transplant community to enact coordinated, system-wide changes that incentivize all parties to work together to maximize every donation opportunity, including from complex, aged, and minority donors, for the focused goal of transplanting more organs.

View AOPO’s full comment letter to CMS.

50,000 Organ Transplants by 2026 Campaign
AOPO’s focus on collaboration is foundational to its recently launched 50,000 Organ Transplants by 2026 Campaign. In this campaign, AOPO and its members will work with key stakeholders to implement a series of system-wide improvement initiatives:

1. Expand collaboration across the AOPO membership and among all stakeholders
2. Reduce health inequities to improve accessibility of organ transplants in minority communities
3. Maximize organ utilization by transplant programs
4. Drive innovation to increase donation and maximize transplantation

We recognize that OPOs are one piece of a larger system and true success comes from hospitals, OPOs, and transplant programs collaborating toward this common goal. By expert stakeholders working together to identify and fix issues within the system, we will ensure our organ donation and transplantation system continues to evolve and get better year over year.

Key Initiative: Expand Collaboration
To expand collaboration in this campaign, AOPO will:

• Work together as dedicated partners within the OPO community to transfer knowledge and learn successful practices to achieve shared goals
• Use data shared within the OPO community to identify areas for individual OPOs to improve their operations to ensure every donation opportunity is maximized
• Develop, in conjunction with the Department of Health and Human Services (HHS), a Learning Collaborative focused on improving donation authorization, organ utilization, organ allocation, and the use of modern technology throughout the donation process.

Collaboration has been at the heart of organ donation improvement for nearly two decades. The Health Resources and Services Administration (HRSA) Collaborative in 2003 brought together the three key stakeholders in organ donation on a national basis: Donor Hospitals, OPOs and Transplant Programs. To this day, essential stakeholders strive to collaborate to remain the best performing donation and transplant system in the world. Collaboration, both within the OPO community and with other stakeholders, is at the heart of AOPO’s plan to grow organ transplantation to 50,000 by 2026.

To date, the following external industry stakeholders have joined us in our campaign effort:

• Association for Multicultural Affairs in Transplantation (AMAT)
• North American Transplant Coordinators Organization (NATCO)
• National Disease Research Interchange (NDRI)
• Donate Life America (DLA)
• Donate Life Chapters – Maryland, Tennessee, New Mexico, Indiana, West Virginia, Mississippi
• New Mexico Lions Eye Bank

I’ll be sharing more information about the AOPO 50,000 Organ Transplants by 2026 Campaign in the near future. For more information about the campaign, visit the AOPO campaign website.

I’m looking forward to the prospect of collaborating with all our stakeholders. Please join us in our collective mission to save more lives.