Des Moines Sun

Sens. Chuck Grassley and Ron Wyden have released a bipartisan report detailing issues within nonprofit Organ Procurement Organizations (OPOs) in the United States. The investigation highlights concerns about transparency, conflicts of interest, and loopholes that affect the organ procurement network's integrity.

The report emphasizes the need for increased transparency to protect organ donors and recipients. It confirms long-standing concerns about OPOs' practices to boost performance ratings and inadequate efforts to address conflicts of interest.

Grassley and Wyden began their investigation during the 118th Congress, continuing their nearly two-decade effort to bring accountability to the organ donation system. "As millions of American families know first-hand, the organ donation system is a matter of life and death," Grassley stated. "Our investigation uncovered clear examples of OPOs exploiting a loophole in direct opposition to congressional intent."

Wyden added, "Americans expect the national organ transplant system to be fair and efficient so as many patients as possible receive the life-saving donation they need."

The investigation reviewed documents from seventeen OPOs, including One Legacy, Donor Alliance, LifeQuest Organ Recovery Services, Indiana Donor Network, Kentucky Organ Donor Affiliates, Mid-America Transplant, New Jersey Organ and Tissue Sharing Network, LifeBanc, Lifeline of Ohio, Texas Organ Sharing Alliance, LifeCenter Organ Donor Network, Midwest Transplant Network, Versiti Wisconsin, LifeShare Network, Gift of Life Donor Program, Tennessee Donor Services and New Mexico Donor Services.

A significant issue identified is a loophole related to pancreata recovered for research. Since CMS introduced a rule in 2020 updating OPO performance metrics without clear verification requirements for research use of organs recovered for research purposes like pancreata—an increase in these recoveries has been noted without corresponding demand from researchers.

Grassley and Wyden have raised this concern since April 2022 with letters to HHS Secretary Becerra and CMS Administrator Brooks-LaSure. They found serious concerns about relationships between OPOs and third-party research clearinghouses or biobanks.

Additionally, Grassley and Wyden asked eight OPOs about their conflict-of-interest policies. The investigation found that CMS does not require uniform policies across organizations leading to differences in definitions and coverage.

Recommendations include clarifying CMS requirements on reporting pancreata recoveries for certification purposes and ensuring comprehensive conflict-of-interest policies among OPOs.

In past years both senators have expressed concerns over financial incentives driving tissue recovery over lifesaving organs within transplant systems. They authored reforms under Securing U.S. Organ Procurement & Transplantation Network Act—the first major reform in nearly four decades aimed at improving accountability across America's organ donation landscape.