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The nation’s organ transplant network has elected a new board of directors in the federal government’s latest effort to reform a flawed system.

For now, the Richmond-based United Network for Organ Sharing acts as the contractor that administers the network, which includes more than 300 transplant hospitals and organ procurement organizations that recover hearts, livers and kidneys from dying donors. The federal government has solicited bids from outsiders and has said it will divvy up UNOS’s work among other companies.

The new Organ Procurement and Transplantation Network board of directors is expected to improve the troubled organ transplant system and eliminate conflicts of interest. But the new board received criticism last week from outgoing members, who say the new panel lacks a diversity of viewpoints and was rushed into existence. Plus, a patient advocate said the industry should not be given the chance to choose its own board.

“I think it is shortsighted if we willfully create a board that’s not representative of the stakeholders we represent,” said Dr. Silas Norman, an outgoing board member. “I think we’re setting ourselves up for trouble.”

20211224_MET_DIFF_UNOS — Employees are seen in the United Network for Organ Sharing office in 2021.
SHABAN ATHUMAN, TIMES-DISPATCH

For years, the members of the organ transplant network board also sat on the board for UNOS. That meant the same people in charge of governing the transplantation organs also were responsible for overseeing the contractor. Critics saw this as a conflict of interest, saying a board could not look out for patients’ best interest and those of UNOS at the same time.

Earlier this year, the federal government announced it would hold an election to replace the current board. This month, the network elected 34 new members — 17 physicians and nine people who received or donated an organ or are the family members of a donor or recipient. Eight others are from the transplant industry. Their term begins July 1.

A physician from Virginia Commonwealth University’s Hume-Lee Transplant Center, Dr. David Bruno, was elected as an associate councilor, meaning he will hold a lower position for two years before he joins the board.

Last week, outgoing members voted not to ratify the new panel. Five current members voted in favor of the new board, while 19 voted against and six abstained. Despite the vote, Robert F. Kennedy Jr., the U.S. Secretary of Health and Human Services, has the authority to seat the newly elected board members, said Andrea Takash, a spokesperson for the federal health department. The agency was “disappointed” in the decision not to ratify, Takash added.

The chosen individuals are sufficiently qualified, said Dr. Richard Formica, current president of the board. But members of the board expressed concern that the selections include too many doctors, too many white men and not enough living donors or family of deceased donors.

Current board members also said the process for selecting new names was rushed and opaque — some nominees failed to make the ballot, while others ran unopposed.

“If we vote for this slate, we are providing legitimacy to this process,” said Dianne LaPointe Rudow, past president of the board. A spokesperson for UNOS, which was not involved in the election, declined to comment.

Molly McCarthy, chair of the network’s patient affairs committee, disapproved of the idea of letting the organ transplant industry elect its own leaders. In other industries, the president or other members of the federal government nominate board members. When hospitals and organ procurement groups choose, they can put in charge people who will seek the best interest of their employer, not the patient, McCarthy said.

Transplant network to switch agencies

The organ transplant network could leave its current agency – the Health Services and Resources Administration – though it’s not clear where it will go.

Congressional committees have indicated the administration of President Donald Trump intends to move the network to the Centers for Medicare and Medicaid Services, or CMS, said Paige Mudd, a spokesperson for UNOS.

Bringing the network under CMS leadership will strengthen the system, Mudd said. CMS already has some oversight and monitoring responsibilities for organ donation — Medicare pays for a significant portion of kidney transplants. CMS is led by Dr. Mehmet Oz, a heart transplant surgeon and television personality who lost a 2022 U.S. Senate election in Pennsylvania.

“UNOS is eager to partner with CMS to create clear, measurable goals for improving the system that will drive meaningful progress for patients and the donor community,” Mudd said.

But Takash, the HRSA spokesperson, said the organ transplant network is likely headed to the Administration for a Healthy America, a new Trump initiative to reorganize the federal Department of Health and Human Services.