Kidney Week 2025 Early Program - Care of Kidney Transplant Candidates and Recipients-Regulatory Updates

Video Transcription

Video Summary

Dr. Mannin reviews major U.S. transplant regulatory and system changes. After ad hoc allocation before 1984, the federal OPTN was created (run for decades by UNOS) and later strengthened with added regulation in 2000. Despite rising transplant volumes, growth has not matched the expanding waiting list, driving calls to maximize access, reduce barriers, improve patient communication, and increase organ supply (including paired exchange, perfusion, and future xenotransplantation). Federal scrutiny intensified with multiple 2022–2024 Senate and House hearings highlighting inequities and troubling donation practices. The bipartisan Securing the U.S. OPTN Act removed HRSA’s funding cap, increased transparency and IT modernization, enabled multiple contracts, and replaced UNOS governance with a new OPTN board and CEO. Organ procurement organizations (OPOs) face new performance metrics, potential decertification, and heightened safety oversight amid public trust concerns. Key trends include stagnating living donation, growth in donation after cardiac death, and increasing non-use of recovered kidneys. A new mandatory CMMI “IOTA” model financially incentivizes transplant volume and organ acceptance.

Asset Subtitle

Roslyn Mannon

Meta Tag

Module TRX

Speaker Roslyn Mannon

Keywords

OPTN reform and governance changes

UNOS replacement and HRSA oversight

Organ procurement organizations performance metrics

Securing the U.S. OPTN Act (2024)

CMMI IOTA transplant payment model